Effectiveness of Elderly Tuberculosis Screening Form in BanPhai Hospital, BanPhai District,KhonKaen Province.

Vivat Mungkhetklang, Samaporn Sopajit

Abstract


TB situation in Thailand and in the region of the Office of Disease Prevention and Control 7thKhonKaen province found that TB incidence increases with age. Therefore the elderly are at risk and their cases need to be intensified case finding. This descriptive study aimed to assess the efficacy of using an elderly TB screening form to detect TB in hospital setting. The sample included 200 elderly people (aged 60 years and over) who received services at the outpatient department BanPhai Hospital, BanPhai district, KhonKaen province during May to July 2014. The elderly tuberculosis screening form was created by Bureau of Tuberculosis and 12 The Office of Disease Prevention and Control was used in data collection. Data was analyzed by using descriptive statistics, sensitivity, specificity, positive predictive values, and negative predictive values. A receiver operating characteristic curve was also performed to determine the diagnostic accuracy of the screening forms. Measuring agreement of each suspected sign and symptoms and factors associated with TB were analyzed by Kappa test.

A total of 200 elderly people were evaluated by an elderly tuberculosis screening form. When considering only risk symptom scores 2, the 167 suspected TB cases (83.50 %) and 33 TB cases were found. 13 active TB cases (7.78 %) were diagnosed from those 167 suspected TB cases. The results of elderly tuberculosis screening revealed that the overall sensitivity and specificity of the screening form were 100 % and 17.65 % respectively, while the positive predictive values and negative predictive values were 7.78 % and 100 % respectively. The diagnostic accuracy of the screening form was 95.84 %. By considering each suspected sign and symptoms, Having an unusual weight loss showed the highest sensitivity, specificity, positive predictive values, and negative predictive values which were 92.31%, 88.24 %, 35.29 % and  99.40%, respectively. Likewise, unusual weight loss showed the highest diagnostic accuracy of the screening form were 90.27 % and highest consistency of suspected tuberculosis symptoms toactive TB disease showed statistical significant (Kappa = 0.46, p-value <0.001). The factors associated with TB include the body mass index, previous close contact of household pulmonary tuberculosis case and previouspulmonary tuberculosis were high specificity (94.55 %, 92.61 % and 93.33 %, respectively). On the other hand, these factors showed no statistical significance (p-value = 0.508, 0.916 and 0.774, respectively).

Results from this study suggest that a hospital may consider the screening form used in this study for screening in hospital setting,especiallyaging warning signs such as unusual weight loss, low fever in afternoon or evening, chest pain and/or chronic cough should be investigated for TB immediately. The initial TB treatment should reduce the severity of the disease, prevent the spread of TB to others and reduce mortality in the elderly with TB.

 


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