Effectiveness of an instructional video for diagnostic sputum production and tuberculosis case detection in Mwananyamala and Temeke hospitals in Dar es Salaam, Tanzania.

Abstract

Introduction Tuberculosis (TB) is second only to HIV as an infectious cause to adult death. The disease remains to be a major global health problem which in 2012 it is estimated that 8.6 million people developed TB and 1.3 million people died from TB worldwide. Sputum smear microscopy remains to be a cornerstone of diagnostic algorithm for TB diagnosis in low-income settings like Tanzania. For diagnosis, presumptive TB cases with coughing for more than two weeks are asked to produce sputum spontaneously from the lungs. However, some cases are missed or given wrong treatment due to patients often giving only saliva from the mouth, which reduces the sensitivity of sputum smears. Methods An interventional study was conducted in Mwanayamala and Temeke hospitals in Dar es Salaam to assess the effectiveness of the video instruction on sputum production and submission for TB case detection. A total of 200 presumptive TB cases were recruited and divided into intervention and control groups. Intervention group received instructions on how to produce sputum by the use of the video prior to sputum collection and control group was instructed to follow routine standard care for sputum production without the use of the video. Results A significant difference was observed on TB case detection among intervention and control groups. TB detection was more on intervention group by (56%) more than control group which was 23% (p<0.05). Quality of sputum was observed to be significantly difference between the intervention and the control groups (p-value; 0.01). Conclusion Instructional provision for sputum production to TB patients has been seen to yield positive results to production of good quality sputum for detection of TB as well as increasing the rate of acid fast bacilli detection among presumptive TB cases when video tools are incorporated into the instructions.