Dataset Information

Measuring and addressing the childhood tuberculosis reporting gaps in Pakistan: The first ever national inventory study among children.

ABSTRACT:

Introduction

Tuberculosis in children may be difficult to diagnose and is often not reported to routine surveillance systems. Understanding and addressing the tuberculosis (TB) case detection and reporting gaps strengthens national routine TB surveillance systems.

Objective

The present study aimed to measure the percentage of childhood TB cases that are diagnosed but not reported to the national surveillance system in Pakistan.

Design

The study design was cross sectional. The study was nationwide in 12 selected districts across Pakistan, each representing a cluster. Health facilities that diagnose and treat childhood TB from all sectors were mapped and invited to participate. Lists of child TB cases were created for the study period (April-June 2016) from all study facilities and compared against the list of child TB cases notified to the national TB surveillance system for the same districts and the same period.

Results

All public and private health facilities were mapped across 12 sampled districts in Pakistan and those providing health services to child TB cases were included in the study. From all private health facilities, 7,125 children were found with presumptive TB during the study period. Of them, 5,258 were diagnosed with tuberculosis: 11% were bacteriologically-confirmed and 89% clinically-diagnosed; only 4% were notified to National TB Control Program. An additional 1,267 children with TB were also registered in the National TB Control Program. Underreporting was measured to be 78%.

Conclusion

This is the first nationwide childhood TB inventory study globally and confirmed that childhood TB underreporting is very high in Pakistan. TB surveillance in the country must be strengthened to address this, with particular attention to guiding and supporting general practitioners and pediatricians to notify their TB cases.

SUBMITTER: Fatima R

PROVIDER: S-EPMC6936771 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Measuring and addressing the childhood tuberculosis reporting gaps in Pakistan: The first ever national inventory study among children.

Fatima Razia R Yaqoob Aashifa A Qadeer Ejaz E Hinderaker Sven Gudmund SG Ikram Aamer A Sismanidis Charalambos C

PloS one 20191230 12

<h4>Introduction</h4>Tuberculosis in children may be difficult to diagnose and is often not reported to routine surveillance systems. Understanding and addressing the tuberculosis (TB) case detection and reporting gaps strengthens national routine TB surveillance systems.<h4>Objective</h4>The present study aimed to measure the percentage of childhood TB cases that are diagnosed but not reported to the national surveillance system in Pakistan.<h4>Design</h4>The study design was cross sectional. T ...[more]

PMID: 31887208

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Project description:OBJECTIVE:The WHO estimates that almost 40% of patients diagnosed with tuberculosis (TB) are not reported. We implemented this study to assess TB under-reporting and delayed treatment registration in nine counties in China. DESIGN:A retrospective inventory study (record review). SETTING:Counties were selected using purposive sampling from nine provinces distributed across eastern, central and western regions of China in 2015. PRIMARY AND SECONDARY OUTCOME MEASURES:Under-reporting was calculated as the percentage of patients with TB not reported to TB Information Management System (TBIMS) within 6?months of diagnosis. Delayed registration was estimated as the percentage of reported cases initiating treatment 7 or more days after diagnosis. Multivariable logistic regression and an alpha level of 0.05 were used to examine factors associated with these outcomes. RESULTS:Of the 5606 patients with TB identified from project health facilities and social insurance systems, 1082 (19.3%) were not reported to TBIMS. Of the 4524 patients successfully reported, 1416 (31.3%) were not registered for treatment within 7 days of diagnosis. Children, TB pleurisy, patients diagnosed in the eastern and central regions and patients with a TB diagnosis recorded in either health facilities or social insurance system-but not both-were statistically more likely to be unreported. Delayed treatment registration was more likely for previously treated patients with TB, patients with negative or unknown sputum results and for patients diagnosed in the eastern region. CONCLUSION:Almost one in every five patients diagnosed with TB in this study was unknown to local or national TB control programmes. We recommend strengthening TB data management practices, particularly in the eastern and central regions, and developing specific guidelines for reporting paediatric TB and TB pleurisy. Patient education and follow-up by diagnosing facilities could improve timely treatment registration. Additional studies are needed to assess under-reporting elsewhere in China.

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Dataset Information

Measuring and addressing the childhood tuberculosis reporting gaps in Pakistan: The first ever national inventory study among children.

Introduction

Objective

Design

Results

Conclusion

Publications

Measuring and addressing the childhood tuberculosis reporting gaps in Pakistan: The first ever national inventory study among children.

Similar Datasets

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