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Pontes TAA, Fernandez-Llimos F, Wiens A. Impact of COVID-19 on tuberculosis notifications. Rev Inst Med Trop Sao Paulo 2024; 66:e37. [PMID: 38865575 PMCID: PMC11164045 DOI: 10.1590/s1678-9946202466037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/15/2024] [Indexed: 06/14/2024] Open
Abstract
The COVID-19 pandemic has significantly impacted the control of diseases by overwhelming healthcare systems, and tuberculosis (TB) notifications may have been affected. This study aimed to analyze the impact of COVID-19 on TB notifications in the Sao Paulo State. This is a retrospective study examining TB notifications extracted from the TBweb database (Jan 2015 to Dec 2022). We conducted an interrupted time series (ITS) analysis of TB notifications using the declaration of the COVID-19 pandemic as the interrupting event (Bayesian causal impact analysis). A total of 177,103 notifications of TB incident cases were analyzed, revealing a significant decrease in 2020 (13%) and in 2021 (9%), which lost significance in 2022. However, changes were not associated with population density or the area of the regions. Future analyses of the effects of TB underdiagnosis might help describe the impact of underreporting on future TB incidence and mortality.
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Affiliation(s)
| | | | - Astrid Wiens
- Universidade Federal do Paraná, Departamento de Farmácia, Curitiba, Paraná, Brazil
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2
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Cattaneo P, Mulongo CM, Morino G, De Vita MV, Paone G, Scarlata S, Kinyita S, Odhiambo H, Mazzi C, Gobbi F, Buonfrate D. Burden of Pulmonary Rifampicin-Resistant Tuberculosis in Kajiado, Kenya: An Observational Study. Microorganisms 2023; 11:1280. [PMID: 37317254 DOI: 10.3390/microorganisms11051280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Rifampicin resistance (RR) is a major challenge in the clinical management of tuberculosis (TB), but data on its prevalence are still sparse in many countries. Our study aimed at estimating the prevalence of RR-TB in Kajiado County, Kenya. Secondary objectives were to estimate the incidence of pulmonary TB in adults and the rate of HIV-TB coinfection. METHODS We conducted an observational study in the context of the ATI-TB Project, carried out in Kajiado. The project was based on an active-case-finding campaign implemented with the aid of village chiefs, traditional healers and community health volunteers. Diagnosis relied on Xpert MTB/RIF, including a mobile machine that could be used to cover areas where testing would otherwise be difficult. RESULTS In sum, 3840 adults were screened for active TB during the campaign. RR cases among all TB diagnoses were 4.6%. The annual incidence of pulmonary TB among adults was 521 cases per 100,000 population. The rate of HIV coinfection was 22.2% among pulmonary TB diagnoses. CONCLUSION The prevalence of RR-TB was four times that what could be inferred from official notifications in Kajiado, and higher than overall prevalence in Kenya. In addition, our estimate of incidence of pulmonary TB in adults in Kajiado significantly differed from cases notified in the same area. In contrast, the rate of HIV coinfection was in line with national and regional data. TB diagnostic capability must be strengthened in Kajiado to improve patients' management and public health interventions.
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Affiliation(s)
- Paolo Cattaneo
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
| | | | - Gianfranco Morino
- World Friends Amici del Mondo Onlus, Ruaraka Uhai Neema Hospital, off Thika Highway, Nairobi P.O. Box 39433-00623, Kenya
| | - Maria Vittoria De Vita
- World Friends Amici del Mondo Onlus, Ruaraka Uhai Neema Hospital, off Thika Highway, Nairobi P.O. Box 39433-00623, Kenya
| | - Gabriele Paone
- World Friends Amici del Mondo Onlus, Ruaraka Uhai Neema Hospital, off Thika Highway, Nairobi P.O. Box 39433-00623, Kenya
| | - Simone Scarlata
- Unit of Internal Medicine, Respiratory Pathophysiology and Thoracic Endoscopy, Fondazione Policlinico Universitario Campus Bio Medico, 00128 Rome, Italy
| | | | | | - Cristina Mazzi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
| | - Federico Gobbi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
| | - Dora Buonfrate
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy
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Widoyo R, Djafri D, Putri ASE, Yani FF, Kusumawati RL, Wongsirichot T, Chongsuvivatwong V. Missing Cases of Bacteriologically Confirmed TB/DR-TB from the National Treatment Registers in West and North Sumatra Provinces, Indonesia. Trop Med Infect Dis 2023; 8:31. [PMID: 36668938 PMCID: PMC9861403 DOI: 10.3390/tropicalmed8010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
This study aimed to assess the percentage of confirmed drug-sensitive (DS) TB and drug-resistant (DR) TB patients who were missing in the national treatment registration in North Sumatra and West Sumatra, where treatment services for DR-TB in North Sumatra are relatively well established compared with West Sumatra, where the system recently started. Confirmed DS/DR-TB records in the laboratory register at 40 government health facilities in 2017 and 2018 were traced to determine whether they were in the treatment register databases. A Jaro-Winkler soundexed string distance analysis enhanced by socio-demographic information matching had sensitivity and specificity over 98% in identifying the same person in the same or different databases. The laboratory data contained 5885 newly diagnosed records of bacteriologically confirmed TB cases. Of the 5885 cases, 1424 of 5353 (26.6%) DS-TB cases and 133 of 532 (25.0%) DR-TB cases were missing in the treatment notification database. The odds of missing treatment for DS-TB was similar for both provinces (AOR = 1.0 (0.9, 1.2), but for DR-TB, North Sumatra had a significantly lower missing odds ratio (AOR = 0.4 (0.2, 0.7). The system must be improved to reduce this missing rate, especially for DR-TB in West Sumatra.
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Affiliation(s)
- Ratno Widoyo
- Epidemiology Unit, Faculty of Medicine, Prince Songkla University, Hat Yai 90110, Thailand
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Universitas Andalas, Padang 25128, Indonesia
| | - Defriman Djafri
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Universitas Andalas, Padang 25128, Indonesia
| | - Ade Suzana Eka Putri
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Universitas Andalas, Padang 25128, Indonesia
| | - Finny Fitry Yani
- Department of Child Health, Faculty of Medicine, Universitas Andalas, Dr. M. Djamil General Hospital, Padang 25128, Indonesia
| | - R Lia Kusumawati
- Department of Microbiology, Faculty of Medicine, Universitas Sumatra Utara, H. Adam Malik Hospital, Medan 20136, Indonesia
| | - Thakerng Wongsirichot
- Division of Computational Science, Faculty of Science, Prince of Songkla University, Hat Yai 90110, Thailand
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4
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COVID-19 and global childhood tuberculosis notifications. Lancet Glob Health 2022; 10:e1691-e1692. [PMID: 36400072 PMCID: PMC9671639 DOI: 10.1016/s2214-109x(22)00453-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022]
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5
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Lungu PS, Kabaso ME, Mihova R, Silumesii A, Chisenga T, Kasapo C, Mwaba I, Kerkhoff AD, Muyoyeta M, Chimzizi R, Malama K. Undernotification and underreporting of tuberculosis in Zambia: a national data quality assessment. BMC Health Serv Res 2022; 22:1074. [PMID: 35996175 PMCID: PMC9396838 DOI: 10.1186/s12913-022-08431-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite national implementation of several high impact interventions and innovations to bolster tuberculosis (TB) detection and improve quality of TB services in Zambia, notifications have been declining since 2004. A countrywide data quality assessment (DQA) of Zambia's National TB and Leprosy Programme (NTLP) was undertaken to quantify the degree to which undernotification and underreporting of TB notifications may be occurring. METHODS The NTLP conducted a retrospective DQA of health facilities in high burden districts in all ten Zambian provinces. Multiple routine programmatic data sources were triangulated through a multi-step verification process to enumerate the total number of unique TB patients diagnosed between 1st January and 31st August 2019; both bacteriologically confirmed and clinically diagnosed TB patients were included. Undernotification was defined as the number of TB patients identified through the DQA that were not documented in facility treatment registers, while underreporting was defined as the number of notified TB cases not reported to the NTLP. RESULTS Overall, 265 health facilities across 55 districts were assessed from which 28,402 TB patients were identified; 94.5% of TB patients were ≥ 15 years old, 65.1% were male, 52.0% were HIV-positive, and 89.6% were a new/relapse case. Among all TB cases, 32.8% (95%CI: 32.2-33.3) were unnotified. Undernotification was associated with age ≥ 15 years old (adjusted prevalence odds ratio [aPOR] = 2.4 [95%CI: 2.0-2.9]), HIV-positive status (aPOR = 1.6 [95%CI: 1.5-1.8]), being a new/relapse TB case (aPOR = 17.5 [95%CI: 13.4-22.8]), being a clinically diagnosed TB case (aPOR = 4.2 [95%CI:3.8-4.6]), and being diagnosed at a hospital (range, aPOR = 1.5 [95%CI: 1.3-1.6] to 2.6 [95%CI: 2.3-2.9]). There was substantial heterogeneity in the proportion of unnotified TB cases by province (range, 18.2% to 43.6%). In a sub-analysis among 22,199 TB patients with further data available, 55.9% (95%CI: 55.2-56.6) were notified and reported to the NTLP, 32.8% (95%CI: 32.2-33.4) were unnotified, and 11.3% (95%CI: 10.9-11.7) went unreported to the NTLP. CONCLUSIONS The findings from Zambia's first countrywide TB programme DQA demonstrate substantial undernotification and underreporting of TB cases across all provinces. This underscores the urgent need to implement a robust and integrated data management system to facilitate timely registration and reporting of all TB patients who are diagnosed and treated.
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Affiliation(s)
| | - M E Kabaso
- Ministry of Health, Lusaka, Zambia.,USAID Sustaining Technical and Analytic Resources (STAR) Project, Lusaka, Zambia
| | - R Mihova
- USAID Eradicate TB Program, Lusaka, Zambia
| | | | | | - C Kasapo
- Ministry of Health, Lusaka, Zambia
| | - I Mwaba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - A D Kerkhoff
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center University of California, San Francisco, San Francisco, CA, USA
| | - M Muyoyeta
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | - K Malama
- Ministry of Health, Lusaka, Zambia
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Hadisoemarto PF, Lestari BW, Sharples K, Afifah N, Chaidir L, Huang CC, McAllister S, van Crevel R, Murray M, Alisjahbana B, Hill PC. A public health intervention package for increasing tuberculosis notifications from private practitioners in Bandung, Indonesia (INSTEP2): A cluster-randomised controlled trial protocol. F1000Res 2022; 10:327. [PMID: 35528962 PMCID: PMC9039369 DOI: 10.12688/f1000research.52089.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background. A significant proportion of tuberculosis (TB) patients globally make their initial visit for medical care to either an informal provider or a private practitioner, and many are not formally notified. Involvement of private practitioners (PPs) in a public–private mix for TB (TB-PPM) provides an opportunity for improving TB control. However, context-specific interventions beyond public–private agreements and mandatory notification are needed. In this study we will evaluate whether a tailored intervention package can increase TB notifications from PPs in Indonesia. Methods. This is a cluster-randomized trial of a multi-component public health intervention. 36 community health centre (CHC) areas will be selected as study locations and randomly allocated to intervention and control arms (1:1). PPs in the intervention areas will be identified using a mapping exercise and recruited into the study if they are eligible and consent. They will receive a tailored intervention package including in-person education about TB management along with bimonthly electronic refreshers, context-specific selection of referral pathways, and access to a TB-reporting app developed in collaboration with the National TB programme. The primary hypothesis is that the intervention package will increase the TB notification rate. The primary outcome will be measured by collecting notification data from the CHCs in intervention and control arms at the end of a 1-year observation period and comparing with the 1-year pre-intervention. The primary analysis will be intention-to-treat at the cluster level, using a generalised mixed model with repeated measures of TB notifications for 1 year pre- and 1 year post-intervention. Discussion. The results from this study will provide evidence on whether a tailored intervention package is effective in increasing the number of TB notifications, and whether the PPs refer presumptive TB cases correctly. The study results will guide policy in the development of TB-PPM in Indonesia and similar settings.
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Affiliation(s)
- Panji Fortuna Hadisoemarto
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Public Health, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Preventive and Social Medicine, Centre for International Health, University of Otago, Dunedin, 9016, New Zealand
| | - Bony Wiem Lestari
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Public Health, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, 6525 GA, The Netherlands
| | - Katrina Sharples
- Department of Mathematics and Statistics, University of Otago, Dunedin, 9016, New Zealand
| | - Nur Afifah
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Lidya Chaidir
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Microbiology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Chuan-Chin Huang
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Susan McAllister
- Department of Preventive and Social Medicine, Centre for International Health, University of Otago, Dunedin, 9016, New Zealand
| | - Reinout van Crevel
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, 6525 GA, The Netherlands
| | - Megan Murray
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Bachti Alisjahbana
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Internal Medicine, Dr Hasan Sadikin General Hospital, Bandung, West Java, 40161, Indonesia
| | - Philip C Hill
- Department of Preventive and Social Medicine, Centre for International Health, University of Otago, Dunedin, 9016, New Zealand
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Sahasrabudhe T, Barthwal M, Sawant T, Ambike S, Jagtap J, Hande S, Atre S. Tuberculosis notification: An inquiry among private practitioners in Pimpri-Chinchwad municipal corporation area of Maharashtra, India. Indian J Tuberc 2022; 69:73-78. [PMID: 35074154 DOI: 10.1016/j.ijtb.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/28/2021] [Accepted: 04/01/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The Government of India implemented mandatory TB notification policy since 2012. After that India's TB notifications from the private sector steadily increased; however, less is known about private practitioners' (PP's) experiences with TB notification. The present study aims to fulfil this gap. METHODS We conducted a cross-sectional study during November 2019 to March 2020 in Pimpri-Chinchwad Municipal Corporation (PCMC) area of Maharashtra State. We used a mixed methods approach which involved a survey of 200 PPs and in-depth interviews (IDIs) with 7 PPs and 8 National TB Elimination Program (NTEP) staff. The data were presented in the form of frequencies and percentages and thematic analysis was performed on the qualitative data. RESULTS The study revealed that most PPs (194 of 200; 97%) were aware of TB notification and 75% reported that they notify TB cases to the NTEP. Of those who notify, majority (129 of 145; 89%) reported that they use paper-based notification being the convenient method due to in-person visit and help by the NTEP staff. Only a third of PPs were aware of electronic notification methods. The main reasons behind low utilization of web based and mobile application were unfamiliarity and technical issues such as poor network connectivity. A third of PPs were aware about monetary incentives for notification and only 17% reported actual receipt of incentive at some point. CONCLUSIONS Our study identifies several areas where the NTEP can undertake interventions to strengthen the implementation of mandatory TB notification policy. Low awareness about electronic notification methods and preference for paper-based notification in this Study area suggest that more efforts are necessary for successful transitioning from paper-based to electronic notification system.
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Affiliation(s)
- Tushar Sahasrabudhe
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Madhusudan Barthwal
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Trupti Sawant
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sunil Ambike
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Jayshri Jagtap
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Shashank Hande
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sachin Atre
- Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, India.
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Meundi AD, Erasmus V, Nagaraja SB, Richardus JH. Voices of Those Who Bear the Brunt - Experiences of Programme Personnel Concerning Private Sector Tuberculosis Notifications in Bengaluru City, India. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:759-769. [PMID: 34478354 DOI: 10.1080/19371918.2021.1953665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study aims to assess private and public sector contributions to Tuberculosis (TB) notification in Bengaluru city (2011 to 2016) and identify challenges of program personnel in their interaction with private practitioners and procedural barriers for TB notification from the private sector as perceived by them. A mixed methods study was carried out in Bengaluru city, India with TB notification data obtained from TB Units in addition to in-depth interviews with key program implementers. Results showed the contribution of private practitioners to TB notification to be about 20%. Barriers and challenges were: the private practitioners' hesitancy to refer the patients to public sector due to their fear of losing patients and dishonoring of diagnosis from private practitioners, lack of awareness about TB notification, lack of legal punitive measures and constant glitches on the notification website. These need to be resolved on priority to achieve the national target of TB elimination by 2025.
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Affiliation(s)
- Anand D Meundi
- Department of Community Medicine, Bowring and Lady Curzon Medical College and Research Institute, Bangalore, India
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vicki Erasmus
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sharath B Nagaraja
- Department of Community Medicine, ESIC Medical College and PGIMSR, Bangalore, India
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Thapa P, Jayasuriya R, Hall JJ, Beek K, Mukherjee P, Gudi N, Narasimhan P. Role of informal healthcare providers in tuberculosis care in low- and middle-income countries: A systematic scoping review. PLoS One 2021; 16:e0256795. [PMID: 34473752 PMCID: PMC8412253 DOI: 10.1371/journal.pone.0256795] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/16/2021] [Indexed: 12/13/2022] Open
Abstract
Achieving targets set in the End TB Strategy is still a distant goal for many Low- and Middle-Income Countries (LMICs). The importance of strengthening public-private partnership by engaging all identified providers in Tuberculosis (TB) care has long been advocated in global TB policies and strategies. However, Informal Healthcare Providers (IPs) are not yet prioritised and engaged in National Tuberculosis Programs (NTPs) globally. There exists a substantial body of evidence that confirms an important contribution of IPs in TB care. A systematic understanding of their role is necessary to ascertain their potential in improving TB care in LMICs. The purpose of this review is to scope the role of IPs in TB care. The scoping review was guided by a framework developed by the Joanna Briggs Institute. An electronic search of literature was conducted in MEDLINE, EMBASE, SCOPUS, Global Health, CINAHL, and Web of Science. Of a total 5234 records identified and retrieved, 92 full-text articles were screened, of which 13 were included in the final review. An increasing trend was observed in publication over time, with most published between 2010–2019. In 60% of the articles, NTPs were mentioned as a collaborator in the study. For detection and diagnosis, IPs were primarily involved in identifying and referring patients. Administering DOT (Directly Observed Treatment) to the patient was the major task assigned to IPs for treatment and support. There is a paucity of evidence on prevention, as only one study involved IPs to perform this role. Traditional health providers were the most commonly featured, but there was not much variation in the role by provider type. All studies reported a positive role of IPs in improving TB care outcomes. This review demonstrates that IPs can be successfully engaged in various roles in TB care with appropriate support and training. Their contribution can support countries to achieve their national and global targets if prioritized in National TB Programs.
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Affiliation(s)
- Poshan Thapa
- School of Population Health, University of New South Wales, Sydney, Australia
- * E-mail:
| | - Rohan Jayasuriya
- School of Population Health, University of New South Wales, Sydney, Australia
| | - John J. Hall
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Kristen Beek
- School of Population Health, University of New South Wales, Sydney, Australia
| | | | - Nachiket Gudi
- The George Institute for Global Health, New Delhi, India
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Tumuhimbise W, Musiimenta A. A review of mobile health interventions for public private mix in tuberculosis care. Internet Interv 2021; 25:100417. [PMID: 34401376 PMCID: PMC8350595 DOI: 10.1016/j.invent.2021.100417] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends the use of mobile health (mHealth) technologies as emerging opportunities to closing the gaps in Tuberculosis (TB) care through enhancing Public Private Mix (PPM). However, little is known about mHealth interventions that have been used for enhancing PPM in TB care, those that worked and those that did not. OBJECTIVE This review summarizes the published evidence on the utilization and effectiveness of mHealth interventions for public private mix in TB care from literature. METHODS Google scholar, PUBMED, IEEE Xplore and ScienceDirect databases were searched for peer reviewed literature from 1st January 2003 to 31st December 2020 for studies about the mHealth interventions for public private mix in TB care. This was guided by the scoping review methodology proposed by Arksey and O' Malley. In order to assess the quality of the selected studies, mHealth evidence reporting and assessment (mERA) checklist was utilized. Studies that discussed the utilization of mHealth interventions for implementing PPM in TB care were included. Nine studies met the inclusion criteria and were analyzed for review. RESULTS The review found out the application of mHealth in Public Private Mix in TB care through the following ways; 1) TB screening, 2) TB case notification 3) TB treatment adherence 4) data collection and management 5) patient referral and follow up, and 6) education. This resulted into high user experience, significant time reduction in data aggregation, increased case notification and referrals and proactive tracking and provision of follow up care hence reduced treatment and completion gaps. One study yielded suboptimal utilization due to the technical and operational challenges encountered by the healthcare workers. CONCLUSION Although this scoping review highlights the role of mHealth technologies in enhancing PPM in TB care, its utilization is still limited in African settings. No Africa-based study was identified by this review. Future studies should focus on assessing the utilization of mHealth for PPM in Africa.
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Affiliation(s)
| | - Angella Musiimenta
- Mbarara University of Science and Technology, Mbarara, Uganda
- Angels Compassion Research and Development Initiative, Mbarara, Uganda
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11
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Hadisoemarto PF, Lestari BW, Sharples K, Afifah N, Chaidir L, Huang CC, McAllister S, van Crevel R, Murray M, Alisjahbana B, Hill PC. A public health intervention package for increasing tuberculosis notifications from private practitioners in Bandung, Indonesia (INSTEP2): A cluster-randomised controlled trial protocol. F1000Res 2021; 10:327. [PMID: 35528962 PMCID: PMC9039369 DOI: 10.12688/f1000research.52089.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 02/13/2024] Open
Abstract
Background. A significant proportion of tuberculosis (TB) patients globally make their initial visit for medical care to either an informal provider or a private practitioner, and many are not formally notified. Involvement of private practitioners (PPs) in a public-private mix for TB (TB-PPM) provides an opportunity for improving TB control. However, context-specific interventions beyond public-private agreements and mandatory notification are needed. In this study we will evaluate whether a tailored intervention package can increase TB notifications from PPs in Indonesia. Methods. This is a cluster-randomized trial of a multi-component public health intervention. 36 community health centre (CHC) areas will be selected as study locations and randomly allocated to intervention and control arms (1:1). PPs in the intervention areas will be identified using a mapping exercise and recruited into the study if they are eligible and consent. They will receive a tailored intervention package including in-person education about TB management along with bimonthly electronic refreshers, context-specific selection of referral pathways, and access to a TB-reporting app developed in collaboration with the National TB programme. The primary hypothesis is that the intervention package will increase the TB notification rate. The primary outcome will be measured by collecting notification data from the CHCs in intervention and control arms at the end of a 1-year observation period and comparing with the 1-year pre-intervention. The primary analysis will be intention-to-treat at the cluster level, using a generalised mixed model with repeated measures of TB notifications for 1 year pre- and 1 year post-intervention. Discussion. The results from this study will provide evidence on whether a tailored intervention package is effective in increasing the number of TB notifications, and whether the PPs refer presumptive TB cases correctly. The study results will guide policy in the development of TB-PPM in Indonesia and similar settings.
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Affiliation(s)
- Panji Fortuna Hadisoemarto
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Public Health, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Preventive and Social Medicine, Centre for International Health, University of Otago, Dunedin, 9016, New Zealand
| | - Bony Wiem Lestari
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Public Health, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, 6525 GA, The Netherlands
| | - Katrina Sharples
- Department of Mathematics and Statistics, University of Otago, Dunedin, 9016, New Zealand
| | - Nur Afifah
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Lidya Chaidir
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Microbiology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Chuan-Chin Huang
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Susan McAllister
- Department of Preventive and Social Medicine, Centre for International Health, University of Otago, Dunedin, 9016, New Zealand
| | - Reinout van Crevel
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, 6525 GA, The Netherlands
| | - Megan Murray
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - Bachti Alisjahbana
- Tuberculosis Working Group, Infectious Disease Research Centre, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
- Department of Internal Medicine, Dr Hasan Sadikin General Hospital, Bandung, West Java, 40161, Indonesia
| | - Philip C Hill
- Department of Preventive and Social Medicine, Centre for International Health, University of Otago, Dunedin, 9016, New Zealand
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Hemalatha K, Thangaraj P. Tuberculosis notification: Facilitators and barriers among private practitioners in Trichy, South India. JOURNAL OF MAHATMA GANDHI INSTITUTE OF MEDICAL SCIENCES 2021. [DOI: 10.4103/jmgims.jmgims_43_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Ahmadi A, Doshmangir L, Gordeev VS, Yazdizadeh B, Majdzadeh R. Behavioral barriers of tuberculosis notification in private health sector: policy implication and practice. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2020. [DOI: 10.1108/ijhg-01-2020-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeUnderreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private sector in TB cases diagnosing. The purpose of this paper was to explore behavioral determinants of underreporting of new TB cases among private sector physicians in Iran.Design/methodology/approachThe authors conducted a population-based, cross-sectional study of physicians working in private clinics. The data collection tool was designed using the theory of planned behavior (TPB). The authors used structural equation models with maximum likelihood estimation to examine attitude toward the notification behavior.FindingsOf 519 physicians, 433 physicians completed the questionnaire. Attitude toward notification had the highest score (mean score = 87.65; sd = 6.79; range: 0–100). The effect of perceived behavioral controls on the notification behavior ((β^) = 0.13; CI: 0.01–0.25) was stronger than the total effect of attitude ((β^) = 0.06; CI: 0.00–0.12) and subjective norms ((β^) = 0.01; CI: −0.00–0.03) on the behavior. However, the attitude was the main predictor of intention and justified 46% of the intention variance. Intention had a significant effect on the behavior ((ß^) = 0.09; CI: 0.1–0.16).Practical implicationsConsidering stronger effect of perceived behavioral control on the behavior, interventions aiming at facilitating notification process would be more effective than those aiming at changing the attitude or enhancing intention among physicians.Originality/valueTo the best of our knowledge, no other study previously explored determinants of underreporting from the behavioral and cognitive perspective. Specifically, the authors explored the role of the TPB constructs in predicting intention to notify new TB cases.
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Boah M, Adampah T, Jin B, Wang W, Wang K. Trend of tuberculosis case notifications and their determinants in Africa and South-East Asia during 2000-2018: a longitudinal analysis of national data from 58 countries. Infect Dis (Lond) 2020; 52:538-546. [PMID: 32431192 DOI: 10.1080/23744235.2020.1761560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: The World Health Organization (WHO) regions of Africa and South-East Asia are the epicentres of the global tuberculosis (TB) epidemic. This study aimed at examining the trend and determinants of TB case notifications in the two regions during 2000-2018.Methods: This was a retrospective analysis of yearly, new TB cases notified to the WHO. We obtained data on potential determinants for the 58 countries in the two regions during 2000-2018. Multivariable longitudinal fixed-effects regression analysis was used to quantify the association between the determinants and TB notifications.Results: During 2000-2018, TB notifications and incidence declined in Africa. In South-East Asia, case notifications increased while the incidence declined, on average, by 2% per year during the same period. After controlling for health, socioeconomic indicators, country and year fixed-effects, each 1% increase in the antiretroviral therapy (ART) coverage and the TB treatment success was associated with a decrease per 100,000 population in the TB case notification rate of -1.62 (95% CI: -4.93, -1.90; p = .037) and -0.91(95% CI: -1.54, -0.28; p = .005) respectively. Similarly, each 1-year increase in the life expectancy at birth resulted in a decrease in TB case notification rates of -6.64 (95% CI: -12.32, -0.95; p = .037). By contrast, a 1% increase in the unemployment rate resulted in an increase in TB notification rate of 3.49 cases (95% CI: 0.19, 6.79; p = .039).Conclusion: Improving population health and the broad scale-up of ART coverage could complement existing TB treatment coverage and cure programmes to drive down new cases in Africa and South-East Asia.
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Affiliation(s)
- Michael Boah
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Ghana Health Service, Upper East Region, Bolgatanga, Ghana
| | - Timothy Adampah
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Education, Culture and Health Opportunities (ECHO) Research Group International, Aflao, Ghana
| | - Baiming Jin
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, China.,Institute of Cell Biotechnology, China and Russia Medical Research Center, Harbin Medical University, Harbin, China
| | - Wenji Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Institute of Cell Biotechnology, China and Russia Medical Research Center, Harbin Medical University, Harbin, China
| | - Kewei Wang
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.,Institute of Cell Biotechnology, China and Russia Medical Research Center, Harbin Medical University, Harbin, China
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15
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Sherpa J, Yadav RP. Perceptions of the Private Sector for Creating Effective Public-Private Partnerships against Tuberculosis in Metro Manila, Philippines. Am J Trop Med Hyg 2019; 101:498-501. [PMID: 31333168 DOI: 10.4269/ajtmh.18-0692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This article's goal is to assess the perspectives of private providers on current and future public-private engagement in Metro Manila, a city of 13 million using semistructured interviews with a convenience sample of 18 private physicians. Our study found that private providers perceived their clientele as loyal and their services as distinct from public services, with unique attractions of convenience and quality of service. They saw value in engaging with the public sector for knowledge exchange, access to public-sector commodities, and access to public sector assistance with public health tasks related to tuberculosis (TB). However, their proposed ways of engaging were more centered on the private sector role, in ways that are not currently being pursued by the public sector. It is of the utmost importance to recognize that private provider perspectives are essential to build effective engagement models and, thus, to reach all clients with quality TB care.
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Affiliation(s)
- James Sherpa
- World Health Organization, Metro Manila, Philippines.,University of Washington, Seattle, Washington
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Ananthakrishnan R, Richardson MD, van den Hof S, Rangaswamy R, Thiagesan R, Auguesteen S, Kamp N. Successfully Engaging Private Providers to Improve Diagnosis, Notification, and Treatment of TB and Drug-Resistant TB: The EQUIP Public-Private Model in Chennai, India. GLOBAL HEALTH: SCIENCE AND PRACTICE 2019; 7:41-53. [PMID: 30926737 PMCID: PMC6538134 DOI: 10.9745/ghsp-d-18-00318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/15/2019] [Indexed: 11/23/2022]
Abstract
Based on a participatory program design that addressed the self-described needs of private providers, a local NGO offered the providers access to rapid diagnostics and support for notification and patient treatment including free anti-TB drugs. The model resulted in high provider participation, contributing more than 10% of the overall TB case notifications, and an 89% treatment success rate for drug-sensitive TB. Background: Private physicians in India see and treat more than half of all people with tuberculosis (TB) each year and thus have potential to make significant contributions to TB control. The EQUIP project was designed as a prospective cohort study to assess the potential of private providers to diagnose and appropriately treat drug-resistant TB (DR-TB) in the Central and South districts of Chennai, India. Methods: The private-sector engagement model consisted of free access to rapid diagnostics; choice of free daily or thrice-weekly treatment regimens; support for notification of patients; and patient support including directly observed therapy through EQUIP centers staffed by a community-based interface agency. Data were collected on provider participation; referral results; treatment regimens prescribed; and treatment outcomes. Results: From October 2015 through June 2017, 227 of the 466 (48.7%) private providers approached referred at least 1 patient to an EQUIP center for evaluation. A total of 2,621 patients received testing and 1,232 (47.0%) were diagnosed with TB. Of those, 727 (59.0%) were bacteriologically confirmed, including 694 (56.3%) using GeneXpert and 33 (2.7%) using smear microscopy. A total of 26 (3.7% of GeneXpert diagnosed) patients were confirmed as rifampicin-resistant cases. EQUIP-related notifications comprised approximately 10% of TB and DR-TB notifications in Chennai during the project period. The project initiated 1,167 (96.8%) drug-sensitive TB patients on treatment. Of those, 691 (59.2%) received standard daily regimens with EQUIP support and 288 (24.7%) received standard intermittent regimens. At the time of writing, 89.4% of 868 drug-susceptible TB patients receiving EQUIP support had treatment success. Of the 26 rifampicin-resistant TB cases notified, 20 (77%) started and continued on second-line treatment; 2 died and 4 were lost to follow-up prior to treatment initiation. Conclusion: Private providers can make a substantial contribution to detection and appropriate treatment of patients with TB and DR-TB in India when provided with access to rapid diagnostics, support for notification and patient treatment through interface agencies, and free, quality anti-TB drugs.
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Affiliation(s)
- Ramya Ananthakrishnan
- REACH (Resource Group for Education and Advocacy for Community Health), Chennai, Tamil Nadu, India
| | - M D'Arcy Richardson
- KNCV Tuberculosis Foundation, The Hague, Netherlands. Now an independent consultant, San Francisco, CA, USA
| | - Susan van den Hof
- KNCV Tuberculosis Foundation, The Hague, Netherlands. Now with the National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Radha Rangaswamy
- REACH (Resource Group for Education and Advocacy for Community Health), Chennai, Tamil Nadu, India
| | - Rajeswaran Thiagesan
- REACH (Resource Group for Education and Advocacy for Community Health), Chennai, Tamil Nadu, India
| | - Sheela Auguesteen
- REACH (Resource Group for Education and Advocacy for Community Health), Chennai, Tamil Nadu, India
| | - Netty Kamp
- KNCV Tuberculosis Foundation, The Hague, Netherlands.
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17
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Şimşek AÇ. Evaluation of the Efficacy of Active Surveillance Practice in Registration and Monitoring of Tuberculosis Patients, in Ankara Province. ANKARA MEDICAL JOURNAL 2019. [DOI: 10.17098/amj.542289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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18
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Siddaiah A, Ahmed MN, Kumar AMV, D’Souza G, Wilkinson E, Maung TM, Rodrigues R. Tuberculosis notification in a private tertiary care teaching hospital in South India: a mixed-methods study. BMJ Open 2019; 9:e023910. [PMID: 30782889 PMCID: PMC6377518 DOI: 10.1136/bmjopen-2018-023910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES India contributes approximately 25% of the 'missing' cases of tuberculosis (TB) globally. Even though ~50% of patients with TB are diagnosed and treated within India's private sector, few are notified to the public healthcare system. India's TB notification policy mandates that all patients with TB are notified through Nikshay (TB notification portal). We undertook this study in a private hospital to assess the proportion notified and factors affecting TB notifications. We explored barriers and probable solutions to TB notification qualitatively from health provider's perspective. STUDY SETTING Private, tertiary care, teaching hospital in Bengaluru, South India. METHODOLOGY This was a mixed-methods study. Quantitative component comprised a retrospective review of hospital records between 1 January 2015 and 31 December 2017 to determine TB notifications. The qualitative component comprised key informant interviews and focus groups to elicit the barriers and facilitators of TB notification. RESULTS Of 3820 patients diagnosed and treated, 885 (23.2%) were notified. Notifications of sputum smear-positive patients were significantly more likely, while notifications of children were less likely. Qualitative analysis yielded themes reflecting the barriers to TB notification and their solutions. Themes related to barriers were: (1) basic diagnostic procedures and treatment promote notification; (2) misconceptions regarding notification and its process are common among healthcare providers; (3) despite a national notification system other factors have prevented notification of all patients; and (4) establishing hospital systems for notification will go a long way in improving notifications. CONCLUSIONS The proportion of patients with TB notified by the hospital was low. A comprehensive approach both by the hospital management and the national TB programme is necessary for improving notification. This includes improving awareness among healthcare providers about the requirement for TB notifications, establishing a single notification portal in hospital, digitally linking hospital records to Nikshay and designating one person to be responsible for notification.
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Affiliation(s)
- Archana Siddaiah
- Department of Community Health, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Mohammad Naseer Ahmed
- St John’s Research Institute, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Ajay M V Kumar
- Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
- Operational Research, International Union Against Tuberculosis and Lung Disease, New Delhi, India
| | - George D’Souza
- Department of Pulmonary Medicine, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Ewan Wilkinson
- Institute of Medicine, University of Chester, Chester, UK
| | - Thae Maung Maung
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Rashmi Rodrigues
- Department of Community Health, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
- Wellcome Trust/DBT India Alliance, Banjara Hills, Hyderabad, India
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19
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Matteelli A, Rendon A, Tiberi S, Al-Abri S, Voniatis C, Carvalho ACC, Centis R, D'Ambrosio L, Visca D, Spanevello A, Battista Migliori G. Tuberculosis elimination: where are we now? Eur Respir Rev 2018; 27:27/148/180035. [PMID: 29898905 DOI: 10.1183/16000617.0035-2018] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/15/2018] [Indexed: 11/05/2022] Open
Abstract
Tuberculosis (TB) still represents a major public health issue in spite of the significant impact of the efforts made by the World Health Organization (WHO) and partners to improve its control. In 2014 WHO launched a new global strategy (End TB) with a vision of a world free of TB, and a 2035 goal of TB elimination (defined as less than one incident case per million). The aim of this article is to summarise the theoretical bases of the End TB Strategy and to analyse progresses and persistent obstacles on the way to TB elimination.The evolution of the WHO recommended strategies of TB control (Directly Observed Therapy, Short Course (DOTS), Stop TB and End TB) are described and the concept of TB elimination is discussed. Furthermore, the eight core activities recently proposed by WHO as the milestones to achieve TB elimination are discussed in detail. Finally, the recently published experiences of Cyprus and Oman on their way towards TB elimination are described, together with the regional experience of Latin America.New prevention, diagnostic and treatment tools are also necessary to increase the speed of the present TB incidence decline.
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Affiliation(s)
- Alberto Matteelli
- University Dept of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV co-infection and for TB elimination, University of Brescia and Brescia Spedali Civili General Hospital, Brescia, Italy
| | - Adrian Rendon
- Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias, Hospital Universitario de Monterrey, Monterrey, México
| | - Simon Tiberi
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
| | | | | | - Anna Cristina C Carvalho
- Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Rosella Centis
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, IRCCS, Tradate, Italy
| | - Lia D'Ambrosio
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, IRCCS, Tradate, Italy.,Public Health Consulting Group, Lugano, Switzerland
| | - Dina Visca
- Pneumology Dept, Maugeri Care and Research Institute, Tradate, Italy
| | - Antonio Spanevello
- Pneumology Dept, Maugeri Care and Research Institute, Tradate, Italy.,Dept of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | - Giovanni Battista Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, IRCCS, Tradate, Italy
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20
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Migliori GB, Sotgiu G, Rosales-Klintz S, Centis R, D'Ambrosio L, Abubakar I, Bothamley G, Caminero JA, Cirillo DM, Dara M, de Vries G, Aliberti S, Dinh-Xuan AT, Duarte R, Midulla F, Solovic I, Subotic DR, Amicosante M, Correia AM, Cirule A, Gualano G, Kunst H, Palmieri F, Riekstina V, Tiberi S, Verduin R, van der Werf MJ. ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update. Eur Respir J 2018; 51:13993003.02678-2017. [PMID: 29678945 DOI: 10.1183/13993003.02678-2017] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 03/11/2018] [Indexed: 12/31/2022]
Abstract
The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, therefore, the standards were reviewed and updated.A panel of international experts, led by a writing group from the European Respiratory Society (ERS) and the European Centre for Disease Prevention and Control (ECDC), updated the ESTC on the basis of new published evidence. The underlying principles of these patient-centred standards remain unchanged. The second edition of the ESTC includes 21 standards in the areas of diagnosis, treatment, HIV and comorbidities, and public health and prevention.The ESTC target clinicians and public health workers, provide an easy-to-use resource and act as a guide through all the required activities to ensure optimal diagnosis, treatment and prevention of TB.
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Affiliation(s)
- Giovanni Battista Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,Contributed equally
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Sassari, Italy.,Contributed equally
| | - Senia Rosales-Klintz
- European Centre for Disease Prevention and Control, Stockholm, Sweden.,Contributed equally
| | - Rosella Centis
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,Contributed equally
| | - Lia D'Ambrosio
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,Public Health Consulting Group, Lugano, Switzerland.,Contributed equally
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | | | - Jose Antonio Caminero
- Pneumology Dept, Hospital General de Gran Canaria "Dr. Negrin", Las Palmas de Gran Canaria, Spain.,MDR-TB Unit, Tuberculosis Division, International Union against Tuberculosis and Lung Disease (The Union), Paris, France
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, Div. of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Masoud Dara
- World Health Organization, Regional Office for Europe, UN City, Copenhagen, Denmark
| | | | - Stefano Aliberti
- School of Medicine and Surgery, University of Milan-Bicocca, UO Clinica Pneumologica, AO San Gerardo, Monza, Italy
| | - Anh Tuan Dinh-Xuan
- Dept of Respiratory Physiology, Cochin Hospital, Paris Descartes University, Paris, France
| | - Raquel Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Dept of Pneumology; Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fabio Midulla
- Dept of Paediatrics, Paediatric Emergency Unit, "Sapienza" University of Rome, Rome, Italy
| | - Ivan Solovic
- National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Catholic University Ruzomberok, Ruzomberok, Slovakia
| | | | - Massimo Amicosante
- Dept of Biomedicine and Prevention and Animal Technology Station, University of Rome "Tor Vergata", Rome, Italy
| | - Ana Maria Correia
- Regional Health Administration of the North, Dept of Public Health, Porto, Portugal
| | - Andra Cirule
- Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia
| | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy
| | - Heinke Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London UK
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy
| | - Vija Riekstina
- Dept of Methodology and Supervision, Riga East University Hospital, Riga, Latvia
| | - Simon Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London UK.,Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Remi Verduin
- Verduin Public Health Consult, Oegstgeest, The Netherlands
| | - Marieke J van der Werf
- European Centre for Disease Prevention and Control, Stockholm, Sweden.,Contributed equally
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Kyu HH, Maddison ER, Henry NJ, Mumford JE, Barber R, Shields C, Brown JC, Nguyen G, Carter A, Wolock TM, Wang H, Liu PY, Reitsma M, Ross JM, Abajobir AA, Abate KH, Abbas K, Abera M, Abera SF, Abera Hareri H, Ahmed M, Alene KA, Alvis-Guzman N, Amo-Adjei J, Andrews J, Ansari H, Antonio CA, Anwari P, Asayesh H, Atey TM, Atre S, Barac A, Beardsley J, Bedi N, Bensenor I, Beyene AS, Butt ZA, Cardona PJ, Christopher D, Dandona L, Dandona R, Deribe K, Deribew A, Ehrenkranz R, El Sayed Zaki M, Endries A, Feyissa TR, Fischer F, Gai R, Garcia-Basteiro AL, Gebrehiwot TT, Gesesew H, Getahun B, Gona P, Goodridge A, Gugnani H, Haghparast-Bidgoli H, Hailu GB, Hassen HY, Hilawe E, Horita N, Jacobsen KH, Jonas JB, Kasaeian A, Kedir MS, Kemmer L, Khader Y, Khan E, Khang YH, Khoja AT, Kim YJ, Koul P, Koyanagi A, Krohn KJ, Kumar GA, Kutz M, Lodha R, Magdy And El Razek H, Majdzadeh R, Manyazewal T, Memish Z, Mendoza W, Mezgebe HB, Mohammed S, Ogbo FA, Oh IH, Oren E, Osgood-Zimmerman A, Pereira D, Plass D, Pourmalek F, Qorbani M, Rafay A, Rahman M, Rai RK, Rao PC, Ray SE, Reiner R, Reinig N, Safiri S, Salomon JA, Sandar L, Sartorius B, Shamsizadeh M, Shey M, Shifti DM, Shore H, Singh J, Sreeramareddy CT, Swaminathan S, Swartz SJ, Tadese F, Tedla BA, Tegegne BS, Tessema B, Topor-Madry R, Ukwaja KN, Uthman OA, Vlassov V, Vollset SE, Wakayo T, Weldegebreal S, Westerman R, Workicho A, Yonemoto N, Yoon SJ, Yotebieng M, Naghavi M, Hay SI, Vos T, Murray CJL. The global burden of tuberculosis: results from the Global Burden of Disease Study 2015. THE LANCET. INFECTIOUS DISEASES 2018; 18:261-284. [PMID: 29223583 PMCID: PMC5831985 DOI: 10.1016/s1473-3099(17)30703-x] [Citation(s) in RCA: 206] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/30/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. METHODS We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated cause-specific mortality, to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. FINDINGS Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10·2 million (95% uncertainty interval 9·2 million to 11·5 million), the number of prevalent cases was 10·1 million (9·2 million to 11·1 million), and the number of deaths was 1·3 million (1·1 million to 1·6 million). Among individuals who were HIV negative, the number of incident cases was 8·8 million (8·0 million to 9·9 million), the number of prevalent cases was 8·9 million (8·1 million to 9·7 million), and the number of deaths was 1·1 million (0·9 million to 1·4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (-4·1% [-5·0 to -3·4]) than in incidence (-1·6% [-1·9 to -1·2]) and prevalence (-0·7% [-1·0 to -0·5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11·4% (9·3-13·0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10·6% (6·8-14·8), and smoking accounted for 7·8% (3·8-12·0). INTERPRETATION Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis. FUNDING Bill & Melinda Gates Foundation.
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van der Werf MJ, Sotgiu G, Dara M. Closing the gap in surveillance of tuberculosis and HIV co-infection: a European perspective on the need for clinician-public health alliances. Eur Respir J 2017; 50:50/5/1701758. [PMID: 29146608 DOI: 10.1183/13993003.01758-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/07/2017] [Indexed: 11/05/2022]
Affiliation(s)
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Masoud Dara
- WHO Regional Office for Europe, Copenhagen, Denmark
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TB Notification from Private Health Sector in Delhi, India: Challenges Encountered by Programme Personnel and Private Health Care Providers. Tuberc Res Treat 2017; 2017:6346892. [PMID: 28845306 PMCID: PMC5563408 DOI: 10.1155/2017/6346892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 04/26/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022] Open
Abstract
Objective To identify the challenges encountered by private health care providers (PHCP) to notify tuberculosis cases through a programme developed web-based portal mechanism called “NIKSHAY.” Study Design. It is a descriptive qualitative study conducted at two revised national tuberculosis control programme (RNTCP) districts of New Delhi. The study included in-depth interviews of PHCP registered with “NIKSHAY” and RNTCP programme personnel. Grounded theory was used to conceptualise the latent social patterns in implementation of tuberculosis case notification process and promptly identifying their challenges. Results The analysis resulted in identification of three broad themes: (a) system implementation by RNTCP: it emphasizes the TB notification process by the RNTCP programme personnel; (b) challenges faced by PHCP for TB notification with five different subthemes; and (c) perceived gaps and suggestions: to improvise the TB notification process for the private health sector. The challenges encountered by PHCP were mainly related to unsystematic planning and suboptimal implementation by programme personnel at the state and district level. The PHCP lacked clarity on the need for TB notification. Conclusion Implementation of TB notification among private health care providers requires systematic planning by the programme personnel. The process should be user-friendly with additional benefits to the patients.
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D'Souza KA, Zaidi SMA, Jaswal M, Butt S, Khowaja S, Habib SS, Malik AA. Factors associated with month 2 smear non-conversion among Category 1 tuberculosis patients in Karachi, Pakistan. J Infect Public Health 2017; 11:283-285. [PMID: 28662884 DOI: 10.1016/j.jiph.2017.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 05/12/2017] [Accepted: 06/09/2017] [Indexed: 11/16/2022] Open
Abstract
Predictors of smear non-conversion at baseline can help identify cases at risk for failure of tuberculosis treatment. Retrospective data for smear-positive Category 1 patients in Karachi, Pakistan, was analyzed. Predictors of sputum conversion were determined using multiple logistic regression with sputum conversion as outcome variable and patient demographics, baseline weight, baseline sputum smear grade, case-finding approach as explanatory variables. Age ≥35 years, baseline sputum grade of 3+ were significantly associated with predicting sputum smear positivity at month 2 of treatment. Monitoring compliance to TB treatment should be considered amongst older patients and those with a high sputum grade at baseline.
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Affiliation(s)
- Kimberly A D'Souza
- Interactive Research & Development, 1-A, North Park Street, Phase 1, Defence Housing Authority, Karachi, Pakistan.
| | - Syed M A Zaidi
- Community Health Solutions, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75300, Pakistan.
| | - Maria Jaswal
- The Indus Hospital, TB Program, Plot C-76, Sector 31/5, Opposite, Korangi Crossing Rd, Karachi, Pakistan.
| | - Shahid Butt
- The Indus Hospital, TB Program, Plot C-76, Sector 31/5, Opposite, Korangi Crossing Rd, Karachi, Pakistan.
| | - Saira Khowaja
- Interactive Research & Development, 1-A, North Park Street, Phase 1, Defence Housing Authority, Karachi, Pakistan.
| | - Shifa S Habib
- Community Health Solutions, Suite 508, Ibrahim Trade Tower, Main Shahrah-e-Faisal, Karachi 75300, Pakistan.
| | - Amyn A Malik
- Interactive Research & Development, 1-A, North Park Street, Phase 1, Defence Housing Authority, Karachi, Pakistan.
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Modelling approaches for tuberculosis: are they realistic? LANCET GLOBAL HEALTH 2017; 5:e268. [PMID: 28193391 DOI: 10.1016/s2214-109x(17)30048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 12/01/2016] [Indexed: 11/21/2022]
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Atre S. Tuberculosis burden in India's private sector. THE LANCET. INFECTIOUS DISEASES 2016; 16:1328-1329. [PMID: 27998589 DOI: 10.1016/s1473-3099(16)30470-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 10/07/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Sachin Atre
- Johns Hopkins University, Centre for Clinical Global Health Education (CCGHE), Baltimore, MD, USA; and Department of Pulmonary Medicine, Dr DY Patil Medical College, Hospital and Research Centre, Pimpri, Pune 411018, India
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