Health Questions and Answers

Question: How should sputum be collected when working up for TB?


  • Patients must be encouraged to bring up sputum and not saliva.
  • Sputum collected first thing in the morning for three consecutive days is recommended
  • Other modified schedules to allow collection in the shortest number of days and clinic visits is likewise acceptable. Advice the patients to collect three sputum specimens within two days as follows:
    • First Specimen: Spot specimen collected at the time of first consultation
    • Second Specimen: Early morning specimen
    • Third Specimen: Second spot specimen collected when patient comes back the next day.

Reference: Crampin A, Floyd S, Mwaungulu F, Black G, Ndhlovu R, Mwaiyeghele E, Glynn JR, Warndoff DK, Fine PE Comparison of two versus three smears in identifying culture-positive tuberculosis patients in rural African setting with high HIV prevalence. Int J Tuberc Lung Dis 2001; 5 (11): 984-999

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