Dataset Information

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

ABSTRACT: Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan.This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment.One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n?=?1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n?=?134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n?=?12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days).Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested.

SUBMITTER: Ali SM

PROVIDER: S-EPMC5845151 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

Ali Syed Mustafa SM Naureen Farah F Noor Arif A Fatima Irum I Viney Kerri K Ishaq Muhammad M Anjum Naveed N Rashid Aamna A Haider Ghulam Rasool GR Khan Muhammad Aamir MA Aamir Javariya J

BMC public health 20180309 1

<h4>Background</h4>Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan.<h4>Methods</h4>This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were co ...[more]

PMID: 29523100

Similar Datasets

Project description:OBJECTIVE:To quantify the prediagnostic loss to follow-up (PDLFU) in an active case finding tuberculosis (TB) programme and identify the barriers and enablers in undergoing diagnostic evaluation. DESIGN:Explanatory mixed-methods design. SETTING:A rural population of 1.02 million in the Samastipur district of Bihar, India. PARTICIPANTS:Based on their knowledge of health status of families, community health workers or CHWs (called accredited social health activist or locally) and informal providers referred people to the programme. The field coordinators (FCs) in the programme screened the referrals for TB symptoms to identify presumptive TB cases. CHWs accompanied the presumptive TB patients to free diagnostic evaluation, and a transport allowance was given to the patients. Thereafter, CHWs initiated and supported the treatment of confirmed cases. We included 13 395 community referrals received between January and December 2018. To understand the reasons of the PDLFU, we conducted in-depth interviews with patients who were evaluated (n=3), patients who were not evaluated (n=4) and focus group discussions with the CHWs (n=2) and FCs (n=1). OUTCOME MEASURES:Proportion and characteristics of PDLFU and association of demographic and symptom characteristics with diagnostic evaluation. RESULTS:A total of 11 146 presumptive TB cases were identified between January and December 2018, out of which 4912 (44.1%) underwent diagnostic evaluation. In addition to the free TB services in the public sector, the key enablers were CHW accompaniment and support. The major barriers identified were misinformation and stigma, deficient family and health provider support, transport challenges and poor services in the public health system. CONCLUSION:Finding the missing cases will require patient-centric diagnostic services and urgent reform in the health system. A community-oriented intervention focusing on stigma, misinformation and patient support will be critical to its success.

Dataset Information

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

Publications

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets