Admission trends of adult TB patients at one of the largest^a tuberculosis hospitals in South Africa: from 2001 to 2003

Abstract

This study describes the epidemiology, clinical pattern and treatment outcomes of tuberculosis (TB) among adult patients in Gauteng. The main objective was to describe the admission trends of TB among new adult patients at the Charles Hurwitz Santa TB Rehabilitation Centre in Soweto from 2001 to 2003. This is the largest TB hospital in South Africa. A retrospective review of 4148 patient records was carried out. This represented 99.8% of all new adult patients admitted during the study period. Data were collected from the hospital TB registers. The study revealed that the gender ratio of admission was 1.6: 1 (M : F). TB admissions increased significantly from 2001 to 2003 and HIV co-infection was shown to be a strong contributory factor to this increase. The overall case fatality rate was 27%. The study showed that the risk factors of mortality among TB patients were the female gender, HIV co-infection, sputum negative TB, increasing age and poor treatment compliance (from patients who had previously defaulted from treatment). Despite the high rate of TB admission and mortality, the study revealed a low rate (4%) of treatment interruption and a high rate (85%) of sputum conversion after an average of nine weeks of treatment. Recommendations that would improve the care of TB patients and enhance TB control include routine HIV testing, the introduction of TB support groups, the integration of TB and HIV treatment and education programmes. Special attention should be paid to young female patients, the elderly, patients with extra-pulmonary TB and those that are sputum negative.