Respiratory infections: SARS and tuberculosis

Positive-microscopy TB is a real issue for the respiratory diseases department of N'Djaména General Hospital, with a prevalence rate of 37 cases in 100 patients. The delay of diagnosis for positive-microscopy TB is excessive. Patients seem to be more responsible for this delay than the healthcare facilities. The factors that delay treatment of TB in N'Djaména are that (1) TB diagnosis in peripheral hospitals lengthens physician delay, and (2) seeking initial treatment outside conventional medicine lengthens patient delay. The following recommendations arise from this study: For the public health ministry: Reboost the national program against TB in Chad. Increase personnel in the respiratory diseases department at the N'Djaména General Hospital. Provide refresher TB education to care providers, stressing the importance of communication with the patient. For the national program against TB in Chad: Initiate a public information, education, and communication campaign about TB. Implement use of DOTS nationwide. For physicians increase communication with patients.