Mortality in smear-negative tuberculosis patients in Phalombe

In two hospitals in Malawi, where HIV prevalence among tuberculosis patients is 80-90%, the treatment outcome in patients registered with smear-negative pulmonary tuberculosis was determined in relation to chest x-ray (CXR) findings and certain laboratory parameters. Of 70 patients who were registered and treated, 32 (46%) were known to have died. Mortality was particularly high in those with a normal / minimally abnormal CXR (62%) and in those with a white cell count of less than 3.5 × 109 /l (77%). The reasons for this high mortality among patients with smear-negative PTB are not known and requires more research.