Comprehensiveness of primary services in the care of infectious tuberculosis patients in Rawalpindi,Pakistan |
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Authors: | R Fatima Q Ejaz D A Enarson K Bissell |
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Institution: | 1.Tuberculosis Control Program Pakistan, Islamabad, Pakistan;2.International Union Against Tuberculosis and Lung Disease, Paris, France |
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Abstract: | Setting:All tuberculosis (TB) diagnostic centres of Rawalpindi District, Pakistan, including five tertiary care hospitals and 16 rural health centres.Objective:To identify among sputum smear-positive patients registered during 2009 in the laboratory register those who had not been recorded in a treatment register, defined in the study as ‘initial loss to follow-up’.Design:A retrospective record review of routine TB data.Results:There were 16 145 suspects screened for TB and recorded in the laboratory registers. Of 1698 smear-positive patients identified in the laboratory registers, 101 (6%) could not be identified in the treatment registers. Eighty-six (10%) of 842 patients in tertiary care hospitals and 15/856 (2%) in rural health centres were not recorded (OR 6.4, 95%CI 3.6–11.6, P < 0.01).Conclusion:The study shows a significant association between type of health facility and initial loss to follow-up. In rural health centres, the proportion lost to follow-up is low, reflecting more efficient care than in tertiary care hospitals. Strategies are urgently needed to improve the registration and follow-up of smear-positive cases in tertiary care institutions. |
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Keywords: | initial loss to follow-up Pakistan tuberculosis |
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