Smear Positivity and Associated Risk Factors among Pulmonary Tuberculosis Suspects at Nigist Eleni Mohammed Memorial Hospital, Hossana, South Ethiopia


Background: Tuberculosis remains to be a major public health problem among the under developed world due to delay in detection and treatment of patients with active TB. In Ethiopia, case detection rate remains low compared with WHO target. Prolonged delay of tuberculosis case detection may lead to disease that is more advanced, high mortality, and continual transmission in the community. Therefore, we aimed to assess the prevalence of smear positive pulmonary tuberculosis and its associated factors among pulmonary tuberculosis suspects at Nigist Eleni Mohammed memorial Hospital, Hossana, South Ethiopia. Method and Materials: A hospital based cross sectional study was conducted at Nigist Eleni Mohammed Memorial Hospital, South Ethiopia from May to June 2013. 186 consecutive pulmonary tuberculosis suspects were included in the study from the hospital outpatient department. Data on demographic and other risk factors were collected using semi-structured questionnaire. Three sputum specimen samples were collected and processed using the standard microbiological method to make sure participants were smear positive. The data were entered into and analyzed using SPSS Version-16 software. Bivariate and multivariate logistic regression analysis was used to identify factors associated with smear positive pulmonary tuberculosis. Result: Of the 186 suspected pulmonary tuberculosis participants, smear positive acid fast bacilli were detected in 18 (9.7%) and 20 (10.8%) by direct and bleach concentrated Zeihl Neelson staining technique respectively. Compared to age group of 15 - 30 there was lower risk of pulmonary tuberculosis for those who were in age group of ≥45 years, [AOR = 0.04, 95% CI: (0.01, 0.36)]. Being male [AOR = 6.56, 95% CI: (1.84, 23.34)], cough duration ≥ 2 weeks [AOR = 10.20, 95% CI: (1.16, 89.48)] and contact with known TB patient at home, [AOR = 5.81 (1.57, 22.31)] were found to have strong association with smear positive pulmonary tuberculosis. Conclusion and recommendation: Higher proportion of smear positivity was found by bleach concentrated technique than direct Zeihl Neelson staining technique. However, case detection rate remains low. Prevention and control of tuberculosis should focus on young age groups between 15 - 30 years. Sustainable health education using various Information Education Communication (IEC) methods including local mass media, early case finding and treatment are recommended to reduce the spread of the disease.

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Tesfaye, D. , Tirore, L. , Beshir, W. and Shimelis, T. (2015) Smear Positivity and Associated Risk Factors among Pulmonary Tuberculosis Suspects at Nigist Eleni Mohammed Memorial Hospital, Hossana, South Ethiopia. Open Access Library Journal, 2, 1-8. doi: 10.4236/oalib.1101423.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] WHO Report (2011) Global Tuberculosis Control. WHO Press, World Health Organization, Geneva.
[2] Abdi, A., Gunnar, B. and Fekadu, A. (2009) Pastoralism and Delay in Diagnosis of TB in Ethiopia. East Afr J Public Health, 6, 156-159.
[3] Federal Ministry of Health (2008) Manual of Tuberculosis and Leprosy and TB/HIV Prevention and Control. 4th Edition, EthioTikur Printing Press, Addis Ababa.
[4] Kondo, T., Hotta, I., Yamanaka, K., Sakakibara, H., Miyoa, M. and Yamada, S. (1993) Family Clusters of Pulmonary Tuberculosis in Suburban Area of Japan. Respiratory Medicine, 87, 205-209.
[5] WHO Regional Office for Africa (2006) Strategic Plan for Tuberculosis Control for the African Region. Harare.
[6] WHO (2010) Transforming the Fight towards Elimination of Tuberculosis: Tuberculosis Prevention and Control Strategic Planning, Financing, Health, Accounting and Budgets. Geneva.
[7] Yimer, S., Bjune, G. and Alene, G. (2005) Diagnostic and Treatment Delay among Pulmonary Tuberculosis Patients in Ethiopia: A Cross Sectional Study. BMC Infectious Diseases, 5, 112.
[8] WHO (2003) Identification of Tuberculosis Suspects: Module 2. Geneva.
[9] Gele, A.A., Bjune, G. and Abebe, F. (2009) Pastoralism and Delay in Diagnosis of TB in Ethiopia. BMC Public Health, 9, 5.
[10] WHO (2006) The Stop TB Strategy: Building on and Enhancing DOTS to Meet the TB-Related MDGs. Geneva.
[11] Yohanes, A., Abera, S. and Ali, S. (2012) Smear Positive Pulmonary Tuberculosis among Suspected Patients Attending Metehara Sugar Factory Hospital; Eastern Ethiopia. African Health Sciences, 12, 325-330.
[12] Cheesbrough, M. (1987) Medical Laboratory Manual for Tropical Countries II. Cambridge University, New York, 255-275.
[13] Ali, H., Zeynudin, A., Mekonnen, A., Abera, S. and Ali, S. (2012) Smear Positive Pulmonary Tuberculosis (PTB) Prevalence amongst Patients at Agaro Teaching Health Center, South West Ethiopia. Ethiopian Journal of Health Sciences, 22, 71-76.
[14] English, R., Bachmann, M., Bateman, E., Zwarenstein, M., Fairall, L., Bheekie, A., Majara, B., Lombard, C., Scherpbier, R. and Ottoman, S. (2006) Diagnostic Accuracy of an Integrated Respiratory Guideline in Identifying Patients with Respiratory Symptoms Requiring Screening for Pulmonary Tuberculosis: A Cross-Sectional Study. BMC Pulmonary Medicine, 6, 22.
[15] Jiménez-Corona, M.E., García-García, L., DeRiemer, K., Ferreyra-Reyes, L., Bobadilla del Valle, M., Cano-Arellano, B., Canizales-Quintero, S., Martínez-Gamboa, A., Sifuentes-Osornio, J. and Ponce-de-León, A. (2006) Gender Differentials of Pulmonary Tuberculosis Transmission and Reactivation in an Endemic Area. Thorax, 61, 348-353.
[16] Tehseen, I., Muhammad, A.R., Zafar, H., Naveed, A. and Salman, A. (2011) Gender Differences among Suspected Pulmonary Tuberculosis Patients Undergoing Sputum Smear Microscopy. Annals of Pakistan Institute of Medical Sciences, 7, 14-17.
[17] Moges, B., Amare, B., Asfaw, F., Tesfaye, W., Tiruneh, M., Belyhun, Y., Mulu, A. and Kassu, A. (2012) Prevalence of Smear Positive Pulmonary Tuberculosis among Prisoners in North Gondar Zone Prison, Northwest Ethiopia. BMC Infectious Diseases, 12, 352.
[18] Dolin, P. (1998) Tuberculosis Epidemiology from a Gender Perspective. In: Diwan, V.K., Thorson, A. and Winkvist, A., Eds., Gender and Tuberculosis, The Nordic School of Public Health, Göteborg, 20-40.
[19] Ogden, J., Rangan, S. and Lewin, S. (1999) Tuberculosis Control in India: A State-of-the-Art Review. The Foundation for Research in Community Health and London, School of Hygiene & Tropical Medicine, London.
[20] Liefooghe, R. (1997) From Their Own Perspective. A Kenyan Community’s Perception of Tuberculosis. Tropical Medicine and International Health, 2, 809-821.
[21] Converse, P.J. (2000) Dual Infection: The Challenge of HIV/AIDS and TB in Ethiopia. Northeast African Studies, 7, 147-165.
[22] Ngowi, B.J., Mfinanga, S.K., Bruun, J.N. and Morkeve, O. (2008) Pulmonary Tuberculosis among People Living with HIV/AIDS Attending Care and Treatment in Rural Northern Tanzania. BMC Public Health, 8, 341.
[23] FDRE, MOH (2010) Tuberculosis Prevention and Control. Addis Ababa.
[24] Rao, V., Gopi, P., Bhat, J., Yadav, R., Selvakumar, N. and Wares, D. (2011) Selected Risk Factors Associated with Pulmonary Tuberculosis among Saharia Tribe of Madhya Pradesh Central India. European Journal of Public Health, 22, 271-273.
[25] Lönnroth, K., Williams, B., Stadlin, S., Jaramillo, E. and Dye, C. (2008) Alcohol Use as a Risk Factor for Tuberculosis—A Systematic Review. BMC Public Health, 8, 289.
[26] Kolappan, C. and Gopi, P. (2002) Tobacco Smoking and Pulmonary Tuberculosis. Thorax, 57, 964-966.

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