Reasons for increased incidence of tuberculosis

BMJ 1995;311:570 (26 August)

Letters

Reasons for increased incidence of tuberculosis

Audit suggests that undernotification is common

EDITOR,--In her editorial Janet H Darbyshire suggests that undernotificationof tuberculosis, particularly in association with HIV infection,is still common.¹ If sufficiently widespread, undernotificationcould result in underestimation of the incidence of tuberculosis,particularly in patients coinfected with HIV, with considerablepublic health implications. We recently audited notificationof tuberculosis in patients known to be infected with HIV whowere attending our hospital.

A database on all patients with mycobacterial infection wasestablished by searching microbiology, histopathology, and clinicalcomputerised records systems. Case notes were then examinedfor all patients. Patients were considered to have tuberculosison the basis of a positive result of culture of a specimen fromany site or either histological or radiographic changes compatiblewith tuberculosis and a response to standard antituberculoustreatment. This database was then cross referenced with a recordof notifications for the whole hospital. The figure . . . [Full text of this article]

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