| Autor: |
Wali A; National Tuberculosis Control Programme, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan.; Provincial Tuberculosis Control Programme, Health Department, Balochistan, Pakistan., Kumar AMV; International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.; The Union, South-East Asia Office, New Delhi, India., Hinderaker SG; Centre for International Health, University of Bergen, Bergen, Norway., Heldal E; Independent Tuberculosis Consultant, Oslo, Norway., Qadeer E; National Tuberculosis Control Programme, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan., Fatima R; National Tuberculosis Control Programme, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan., Ullah A; Provincial Tuberculosis Control Programme, Health Department, Balochistan, Pakistan., Safdar N; Centre for International Health, University of Bergen, Bergen, Norway.; Social and Health Inequalities Network, Islamabad, Pakistan., Yaqoob A; National Tuberculosis Control Programme, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan., Anwar K; Bridge Consultants Foundation, Karachi, Pakistan., Ul Haq M; National Tuberculosis Control Programme, Ministry of National Health Services, Regulation and Coordination, Islamabad, Pakistan. |
| Abstrakt: |
Setting: Three public sector tertiary care hospitals in Quetta, Balochistan, Pakistan, with anecdotal evidence of gaps between the diagnosis and treatment of patients with tuberculosis (TB). Objectives: To assess the proportion of pre-treatment loss to follow-up (LTFU), defined as no documented evidence of treatment initiation or referral in TB registers, among smear-positive pulmonary TB patients diagnosed in 2015, and the associated sociodemographic factors. Design: A retrospective cohort study involving the review of laboratory and TB registers. Results: Of 1110 smear-positive TB patients diagnosed (58% female, median age 40 years, 5% from outside the province or the country), 235 (21.2%) were lost to follow-up before starting treatment. Pre-treatment LTFU was higher among males; in patients residing far away, in rural areas, outside the province or the country; and in those without a mobile phone number. Conclusion: About one fifth of the smear-positive TB patients were lost to follow-up before starting treatment. Strengthening the referral and feedback mechanisms and using information technology to improve the tracing of patients is urgently required. Further qualitative research is needed to understand the reasons for pre-treatment LTFU from the patient's perspective. |
