Korean J Med.  2009 Jan;76(1):44-51.

The diagnostic accuracy of notified new culture-negative pulmonary tuberculosis patients in public healthcare centers

• Heo E
• Oh SY
• Jeong I
• Lee JS
• Lim HJ
• Park YS
• Lee JW
• Han SK
• Lee CH

Abstract

BACKGROUND/AIMS
The notification rate based on the Korean tuberculosis (TB) surveillance system has been widely used to evaluate the TB burden in Korea. However, few studies have examined the accuracy of TB diagnosis among notified cases. This study evaluated the diagnostic accuracy of microbiologically not proven cases notified as 'new pulmonary TB patients' at public healthcare centers.
METHODS
We reviewed the clinical symptoms and initial and follow-up chest radiographs of notified smear-and-culture- negative TB cases in randomly selected healthcare centers between Jan 2005 and Dec 2005. Patients who had symptoms, initial chest radiographs compatible with pulmonary TB, and radiological improvements after treatment were diagnosed as 'probable TB', while patients who did not meet these three criteria were diagnosed as 'probably not TB'.
RESULTS
The analysis included 263 patients. The median age of the notified TB cases was 41 years, 60.8% of them were male, and 43.2% were 'probable TB' patients. Overall, 82.0% of the patients had either initial chest radiographs compatible with pulmonary TB or radiological improvements after treatment. Ultimately, 4.9% were 'probably not TB' patients.
CONCLUSIONS
Most of the new notified pulmonary TB patients not confirmed microbiologically in public clinics can be considered real TB patients, although there are some over diagnosed cases.

Keyword

Public sector; Tuberculosis; Diagnosis

MeSH Terms

Delivery of Health Care
Follow-Up Studies
Humans
Korea
Male
Public Sector
Thorax
Tuberculosis
Tuberculosis, Pulmonary