Are patients who present spontaneously with PTB symptoms to the health services in Burkina Faso well managed?

SETTING: Six health districts selected from a total of 53 in Burkina Faso.

OBJECTIVE: To evaluate the performance of the health services in identifying infectious pulmonary tuberculosis (PTB) cases in Burkina Faso.

DESIGN: Retrospective review of initial consultation registers in the first level health centres and the laboratory and treatment registers kept at the Centres for TB Diagnosis and Treatment (CDTs) in 2001.

RESULTS: The rate of detection of sputum-positive cases of PTB was 11.7 cases per 100000 population. Cough was the reason for consulting for 10.6% of 248,730 adults; 1.1% had chronic cough. Among patients with chronic cough, 66% had been referred for smear microscopy, 69.7% of whom were registered at the CDT to which they were referred. A positive diagnosis was made in 22.5% of the suspects referred and traced to the CDT. Among those with a positive diagnosis, 87.1% were put on treatment in the same CDT.

CONCLUSIONS: The PTB case detection rate in Burkina Faso is low, due to the loss of cases at each of the stages leading to the diagnosis of TB. Case detection depends on the operational effectiveness of the staff working in the health services, as well as the referral of suspect patients to the CDT.