Where, when, and how many tuberculosis patients are lost from presumption until treatment initiation? A step by step assessment in a rural district in Zimbabwe
| Autor: | Admire S. Murongazvombo, Susumu Hirao, Hemant Deepak Shewade, Valerie J. Robertson, Elijah Pikira, Cremence Tshuma, Rachael K. Taruvinga, Precious Andifasi, Riitta A Dlodlo, Cedric Zhanero |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male Zimbabwe medicine.medical_specialty Tuberculosis Time Factors Adolescent 030106 microbiology Rural Health lcsh:Infectious and parasitic diseases Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans lcsh:RC109-216 030212 general & internal medicine business.industry Technician Rural health Presumption Rural district General Medicine Middle Aged medicine.disease Confidence interval Infectious Diseases Family medicine Sputum Female medicine.symptom business Cohort study |
| Zdroj: | International Journal of Infectious Diseases, Vol 78, Iss, Pp 113-120 (2019) |
| ISSN: | 1878-3511 |
| Popis: | Objectives: To describe the pre-diagnosis and pre-treatment loss to follow-up (LTFU) in the tuberculosis (TB) care cascade in Guruve (2015–16), a rural district in Zimbabwe. Design: Guruve has 19 rural health centres (RHCs) and one district hospital. In this cohort study, persons ≥15 years of age with presumptive pulmonary TB were tracked from the facility presumptive TB registers to the laboratory registers; if laboratory diagnosed, they were tracked to the district TB register (contains details of all TB patients registered for treatment). Each patient was tracked for 90 days after registration as presumptive TB and for 90 days after laboratory diagnosis. Environmental health technicians transported sputum specimens from the health facilities to the laboratories (n = 3). Results: Of 2974 persons with presumptive TB, pre-diagnosis LTFU occurred in 575 (19%, 95% confidence interval 18–21%). Associated factors included registration at a RHC, at a facility more than 2 km from the laboratory, and absence of an environmental health technician. Of 162 laboratory diagnosed pulmonary TB patients, pre-treatment LTFU occurred in 19 (12%, 95% confidence interval 8–18%). Conclusions: The presumptive TB register was helpful to assess the pre-diagnosis gaps beginning from presumption. Pre-diagnosis LTFU can be reduced by placement of an environmental health technician at all facilities. Keywords: Tuberculosis/diagnosis, Tuberculosis/treatment, Early diagnosis, SORT IT, Operational research, Pre-diagnosis loss to follow-up, Pre-treatment loss to follow-up, Diagnosis and treatment cascade |
| Databáze: | OpenAIRE |
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