Drug-resistant tuberculosis patient care journeys in South Africa: a pilot study using routine laboratory data
| Autor: | Karina Kielmann, Koleka Mlisana, Mosa Moshabela, S Le Roux, Waasila Jassat, L. Mitrani, Marian Loveday, Helen Cox, John Black, Mark P. Nicol, Lindy Dickson-Hall, C Grundy, Jeremy Hill, Alison D. Grant |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Tuberculosis 030231 tropical medicine Pilot Projects Patient care 03 medical and health sciences South Africa 0302 clinical medicine Health facility Interquartile range Health care Tuberculosis Multidrug-Resistant medicine Humans 030212 general & internal medicine business.industry Drug resistant tuberculosis Routine laboratory medicine.disease Infectious Diseases Family medicine Patient Care Rural area business Laboratories |
| Zdroj: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 24(1) |
| ISSN: | 1815-7920 1027-3719 |
| Popis: | SETTING: Thirteen districts in Eastern Cape (EC), KwaZulu-Natal (KZN) and Western Cape (WC) Provinces, South Africa.OBJECTIVE: To pilot a methodology for describing and visualising healthcare journeys among drug-resistant tuberculosis (DR-TB) patients using routine laboratory records.DESIGN: Laboratory records were obtained for 195 patients with laboratory-detected rifampicin-resistant TB (RR-TB) during July–September 2016. Health facility visits identified from these data were plotted to visualise patient healthcare journeys. Data were verified by facility visits.RESULTS: In the 9 months after the index RR-TB sample was collected, patients visited a mean of 2.3 health facilities (95% CI 2.1–2.6), with 9% visiting ≥4 facilities. The median distance travelled by patients from rural areas (116 km, interquartile range [IQR] 50–290) was greater than for urban patients (51 km, IQR 9–140). A median of 21% of patient's time was spent under the care of primary healthcare facilities: this was respectively 6%, 37% and 39% in KZN, EC and WC. Journey patterns were generally similar within districts. Some reflected a semi-centralised model of care where patients were referred to regional hospitals; other journeys showed greater involvement of primary care.CONCLUSION: Routine laboratory data can be used to explore DR-TB patient healthcare journeys and show how the use of healthcare services for DR-TB varies in different settings. |
| Databáze: | OpenAIRE |
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