Cytological findings in sputum submitted by tuberculosis suspects at ngong sub-district hospital and Ongata Rongai health centre in Kajiado county

Abstract

Background- Sputum cytology is noninvasive and is the most easily obtainable of the cytologic techniques available. Spontaneous production of significant amounts of sputum often indicates pulmonary disease, both tuberculosis and other respiratory conditions present with similar symptoms. Objective- To describe cytomorphologic changes in sputum samples submitted by TB suspect patients. Settings and Design- Cross-sectional descriptive study. A total 196 TB suspect patients seen at Ngong Sub-District Hospital and Ongata Rongai Health Centre in Kajiado County between December 2011 and March 2012 were assessed for criteria and enrolled in the study. Materials and Methods- Two pre-fixed sputum (Spot and morning) samples were obtained from 196 consecutive pulmonary TB suspect patients, pooled, centrifuged and processed for H&E, Pap and Concentration ZN techniques. Statistical analysis- The data was presented in percentages and charts. The significance of difference was tested using Chi- square test. Quantitative ., risk assessment by the Odds Ratios (OR) with 95% confidence intervals. The enti e data was analyzed using SPSS version 17. Results- In this study 52% of the TB suspects had abnormal cytological findings. Benign specific lesions were 32%, atypical benign (reactive/reparative) were 15%, and atypical suspicious for malignancy 5%. Specific benign lesions were most common lesions, tuberculosis being the commonest. Smokers accounted for 33% of the study population, 42% of the smokers were between 30-44 years and 36% had abnormal srnears. There was significant correlation between smoking and abnormal cytologic findings OR 0.5 (95% CI 0.3-1.0), P=0.&35. There was no significant correlation J . between abnormal cytologic findings and factors such as: age, gender, number of cigarettes smoked, fam!ly history of chronic respiratory conditions and the occupation. Conclusion Sputum cytology is a reliable diagnostic tool in identifying and describing cytomorphologic changes of respiratory tract conditions. There was a positive correlation between cigarette smoking and abnormal cytologic findings. Recommendations Sputum cytology should be done in patients with symptoms of respiratory tract diseases. Patients with respiratory tract disease symptoms should be educated on adverse effects of smoking.