PURPOSE: BACKGROUND: The global burden of tuberculosis cannot be underestimated and accurate symptom-based screening is important in increasing case detection rates, especially in high burden countries. Local and international consensus data focus on cough as the main symptom to be sought for. However, other studies found out that symptoms like, weight loss, fever, and hemoptysis were more sensitive predictors. OBJECTIVE: To determine the accuracy of cough and other presenting symptoms in predicting the activity of pulmonary tuberculosis.
METHODS: STUDY DESIGN: A database review of the patients seen at the USTH Center for Respiratory Medicine from September 2004 up to August 2007 was done. 512 patients were included and data regarding the symptoms of pulmonary TB, sputum AFB smear, and sputum MTB culture were recorded.
RESULTS: RESULTS: Cough was the most sensitive symptom in predicting active PTB, with a likelihood ratio of 4.4. However, the negative predictive value was only at 19%. For sputum AFB smear, the symptoms found to have a significant positive correlation were cough, fever, night sweats, weight loss, and hemoptysis. Those with positive sputum MTB culture were positively correlated with cough and hemoptysis.
CONCLUSION: CONCLUSION: Cough is the most sensitive screening symptom for active tuberculosis, though with a likelihood ratio of only 4.4. Other additional symptoms (weight loss, fever, night sweats, and hemoptysis) should be sought for since their presence correlated with active pulmonary tuberculosis.
CLINICAL IMPLICATIONS: In increasing case detection rates of pulmonary tuberculosis, it is important to note that cough still remains to be the most sensitive symptom in predicting activity. Additional symptoms like weight loss, fever, night sweats, and hemoptysis should increase clinical suspicion more.
DISCLOSURE: Julie Christie Visperas, No Financial Disclosure Information; No Product/Research Disclosure Information