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Martinson, Jocelyn Moyes, Adam L. Understanding the burden and clinical presentation of tuberculosis in patients with severe respiratory illness SRI has important implications for anticipating treatment requirements. We enrolled individuals with SRI. In this setting, tuberculosis, including acute presentation, is common in patients hospitalized with SRI. Tuberculosis is an important cause of severe respiratory illness SRI causing significant morbidity and mortality globally.
In , an estimated The , South African national guidelines for tuberculosis management recognized the importance of early diagnosis and treatment of tuberculosis and advocated that sputa be tested in patients with symptoms of tuberculosis, especially those who are infected with HIV irrespective of the duration of cough. The World Health Organization WHO guidelines also call for intensified case finding among HIV-infected individuals and recommend screening for tuberculosis in patients with any current symptoms of tuberculosis [ 3 ].
In addition, clinicians were significantly less likely to test patients with acute symptoms for tuberculosis and to start them on tuberculosis treatment [ 4 ]. Understanding the spectrum of clinical presentation of tuberculosis may contribute to timely diagnosis and treatment and subsequent better control of the tuberculosis epidemic.
This study used data collected as part of surveillance for SRI [ 5 ]. A case of SRI was defined as admission with a physician diagnosis of LRTI eg, pneumonia, bronchiolitis, bronchitis, and pleural effusion, suspected or confirmed tuberculosis irrespective of symptom duration and included individuals who met the WHO severe acute respiratory illness SARI case definition of cough and fever presenting within 10 days of onset of illness [ 6 ].
Patients admitted from Sunday at 5: Patients who refused or were unable to give consent and patients from outside the catchment area of the respective hospitals were excluded. Data on clinical presentation, previous medical history, antiviral therapy for HIV-infected individuals, inpatient investigations, and management and outcome were collected by interview and medical record review. Patients were followed-up until discharge. Treatment decisions, including initiation of tuberculosis treatment based on laboratory confirmation or empirically, and diagnostic tests were performed according to the attending physician.