Pulmonary tuberculosis in Ibadan: a ten-year review of laboratory reports (1996-2005)

Tuberculosis (TB) control programme is a balance between accurate diagnosis of the disease and effective treatment of cases to eliminate the disease in the community. We carried out a retrospective review of the specimens processed in the TB laboratory of the Department of Medical Microbiology, University College Hospital, Ibadan between 1996 and 2005. Majority of the specimens processed were sputum (75.2%) while cerebrospinal fluid and aspirates from other sources accounted for 4.3% and 20.5% respectively. Of the sputum processed, 2,738 (62.4%) were from male patients while 1,650(37.6%) were from female patients giving a male to female ratio of 1.66:1.00. Only 380 (9.5%) were reported smear positive while 477 (10.9%) were positive for culture. Three hundred and four (6.9%) were smear negative but culture positive while 207 (4.7%) were smear positive but negative for culture. Those sputum that were missed by smear microscopy (6.9%) were only confirmed by culture after six to eight weeks incubation. This culture method is only available in few reference centers in Nigeria. Thus, undiagnosed cases resulting from inadequate diagnostic facilities contribute an impediment to TB control efforts in the community. Hence there is an urgent need to have more accurate, affordable tools that would be available for use at the all levels of health care to achieve total eradication of TB in the community.