S Ram1, K Kishore1, I Batio2, K Bissell3, R Zachariah4, S Satyanarayana3, A D Harries5. 1. Fiji National University, Suva, Fiji. 2. Fiji National Tuberculosis Programme, Suva, Fiji. 3. International Union Against Tuberculosis and Lung Disease, Paris, France. 4. Médecins Sans Frontières (MSF)-Operational Centre Brussels, Luxembourg. 5. International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
Abstract
SETTING: All tuberculosis (TB) diagnostic and treatment centres in Fiji. OBJECTIVES: To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services. METHODS: A retrospective review of routine programme data reconciling TB laboratory and treatment registers. RESULTS: A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001). CONCLUSION: This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
SETTING: All tuberculosis (TB) diagnostic and treatment centres in Fiji. OBJECTIVES: To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services. METHODS: A retrospective review of routine programme data reconciling TB laboratory and treatment registers. RESULTS: A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001). CONCLUSION: This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
Entities:
Keywords:
Fiji; laboratory register; operational research; pre-treatment loss to follow-up; tuberculosis
Authors: S B Squire; A K Belaye; A Kashoti; F M L Salaniponi; C J F Mundy; S Theobald; J Kemp Journal: Int J Tuberc Lung Dis Date: 2005-01 Impact factor: 2.373
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Bull World Health Organ Date: 2007-11 Impact factor: 9.408
Authors: B Sai Babu; A V V Satyanarayana; G Venkateshwaralu; U Ramakrishna; P Vikram; S Sahu; F Wares; P K Dewan; K Santosha; J Jyoti; S Srinath; R Chethana; T Neelima; P Vinod; M Yogesh; L S Chauhan Journal: Int J Tuberc Lung Dis Date: 2008-09 Impact factor: 2.373
Authors: E Botha; S Den Boon; S Verver; R Dunbar; K-A Lawrence; M Bosman; D A Enarson; I Toms; N Beyers Journal: Int J Tuberc Lung Dis Date: 2008-07 Impact factor: 2.373
Authors: R Zachariah; A D Harries; S Srinath; S Ram; K Viney; E Singogo; P Lal; A Mendoza-Ticona; A Sreenivas; N W Aung; B N Sharath; H Kanyerere; N van Soelen; N Kirui; E Ali; S G Hinderaker; K Bissell; D A Enarson; M E Edginton Journal: Int J Tuberc Lung Dis Date: 2012-06 Impact factor: 2.373
Authors: E Botha; S den Boon; K-A Lawrence; H Reuter; S Verver; C J Lombard; C Dye; D A Enarson; N Beyers Journal: Int J Tuberc Lung Dis Date: 2008-08 Impact factor: 2.373
Authors: A Wali; A M V Kumar; S G Hinderaker; E Heldal; E Qadeer; R Fatima; A Ullah; N Safdar; A Yaqoob; K Anwar; M Ul Haq Journal: Public Health Action Date: 2017-03-21
Authors: A M V Kumar; S Satyanarayana; S Dar Berger; S S Chadha; R J Singh; P Lal; J Tonsing; A D Harries Journal: Public Health Action Date: 2015-03-21
Authors: Peter MacPherson; Rein M G J Houben; Judith R Glynn; Elizabeth L Corbett; Katharina Kranzer Journal: Bull World Health Organ Date: 2013-11-22 Impact factor: 9.408