V K Chadha1, Bhoomika Bajaj Bhalla2, Sowmya B Ramesh3, J Gupta2, N Nagendra2, R Padmesh2, J Ahmed2, R K Srivastava2, R K Jaiswal2, P Praseeja2. 1. Epidemiology and Research Division, National Tuberculosis Institute, Bangalore, Karnataka, India. Electronic address: vineet2.chadha@gmail.com. 2. Epidemiology and Research Division, National Tuberculosis Institute, Bangalore, Karnataka, India. 3. Department of Family Medicine, P D Hinduja Hospital, Bangalore, India.
Abstract
SETTING: Implementation study in private health facilities in an Indian metropolis. OBJECTIVES: Improve Tuberculosis (TB) care by private practitioners (PPs). METHODS: PPs from a defined city area were imparted short training in TB care and linkages made with public facilities; subsequent practices were recorded. RESULTS: Of 364 presumptive TB patient records, 70 (19.3%) did not conform to its definition. Of the conforming, 174 (59.2%) had presumptive pulmonary TB (PTB), 53 (18%) presumptive extra-pulmonary (EPTB) and 67 (24%) had both. Of conforming presumptive PTB, most underwent Chest X-ray and sputum examination in private laboratories. Tissue based diagnostics were not advised for most presumptive EPTB patients. Of 101 cases diagnosed with TB, 82% were new, 23% known diabetic and 4.7% human immune deficiency virus (HIV) reactive out of 64 tested. Most were notified and initiated treatment within 15 days of diagnosis. One-fourth was prescribed standard treatment regimen and treatment was not directly observed for most. One third was initial defaulters or lost during treatment; 62% of PTB and 46% EPTB cases initiated on treatment in private were successfully treated. Of successfully treated PTB cases, 61% had undergone follow-up sputum examination. CONCLUSION: Much intensified support mechanisms are needed to improve TB care in private sector.
SETTING: Implementation study in private health facilities in an Indian metropolis. OBJECTIVES: Improve Tuberculosis (TB) care by private practitioners (PPs). METHODS: PPs from a defined city area were imparted short training in TB care and linkages made with public facilities; subsequent practices were recorded. RESULTS: Of 364 presumptive TB patient records, 70 (19.3%) did not conform to its definition. Of the conforming, 174 (59.2%) had presumptive pulmonary TB (PTB), 53 (18%) presumptive extra-pulmonary (EPTB) and 67 (24%) had both. Of conforming presumptive PTB, most underwent Chest X-ray and sputum examination in private laboratories. Tissue based diagnostics were not advised for most presumptive EPTB patients. Of 101 cases diagnosed with TB, 82% were new, 23% known diabetic and 4.7% humanimmune deficiency virus (HIV) reactive out of 64 tested. Most were notified and initiated treatment within 15 days of diagnosis. One-fourth was prescribed standard treatment regimen and treatment was not directly observed for most. One third was initial defaulters or lost during treatment; 62% of PTB and 46% EPTB cases initiated on treatment in private were successfully treated. Of successfully treated PTB cases, 61% had undergone follow-up sputum examination. CONCLUSION: Much intensified support mechanisms are needed to improve TB care in private sector.
Authors: Peter S Azzopardi; Julie Hennegan; Shirley Mark Prabhu; Bolorchimeg Dagva; Mx Mar Balibago; Pa Pa Win Htin; Zay Yar Swe; Elissa C Kennedy Journal: Lancet Reg Health West Pac Date: 2021-08-05