J Noeske, A Mzembaba, Y Assoumani, S Maoulida, A Makpenon
{"title":"评估科摩罗联盟的结核病诊断和治疗。","authors":"J Noeske, A Mzembaba, Y Assoumani, S Maoulida, A Makpenon","doi":"10.5588/pha.22.0057","DOIUrl":null,"url":null,"abstract":"<p><strong>Setting: </strong>The Union of the Comoros has experienced a persistent notification gap in TB cases despite several strategic changes, including molecular diagnosis and contact investigation. We therefore performed a TB patient pathway analysis (PPA) under the National Tuberculosis Programme (NTP).</p><p><strong>Objective: </strong>To assess the alignment of healthcare-seeking behaviour and TB service availability to clarify the reasons for these missing cases.</p><p><strong>Design: </strong>Three primary data sources, including a national list of health facilities, TB surveillance data and care-seeking behaviour data, were analysed at the national and regional levels to determine access to TB diagnosis and the initial point of care-seeking. Summary data were visualised using the standardised PPA Wizard programme, and the analysis was completed using demographic and socio-economic data.</p><p><strong>Results: </strong>At the initial point of care-seeking, 18% of patients had access to TB services, available only in nine centralised public health facilities. Furthermore, 30% of patients initially consulted in the informal sector and 45% in the formal public or private sector in health facilities, both of which lacked the capacity for TB diagnosis or first-line treatment.</p><p><strong>Conclusion: </strong>The concentration of and limited access to TB services at the intermediate and central levels of care indicate a need for decentralisation efforts.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162367/pdf/i2220-8372-13-1-23.pdf","citationCount":"0","resultStr":"{\"title\":\"Evaluating TB diagnosis and care in the Union of the Comoros.\",\"authors\":\"J Noeske, A Mzembaba, Y Assoumani, S Maoulida, A Makpenon\",\"doi\":\"10.5588/pha.22.0057\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Setting: </strong>The Union of the Comoros has experienced a persistent notification gap in TB cases despite several strategic changes, including molecular diagnosis and contact investigation. We therefore performed a TB patient pathway analysis (PPA) under the National Tuberculosis Programme (NTP).</p><p><strong>Objective: </strong>To assess the alignment of healthcare-seeking behaviour and TB service availability to clarify the reasons for these missing cases.</p><p><strong>Design: </strong>Three primary data sources, including a national list of health facilities, TB surveillance data and care-seeking behaviour data, were analysed at the national and regional levels to determine access to TB diagnosis and the initial point of care-seeking. Summary data were visualised using the standardised PPA Wizard programme, and the analysis was completed using demographic and socio-economic data.</p><p><strong>Results: </strong>At the initial point of care-seeking, 18% of patients had access to TB services, available only in nine centralised public health facilities. Furthermore, 30% of patients initially consulted in the informal sector and 45% in the formal public or private sector in health facilities, both of which lacked the capacity for TB diagnosis or first-line treatment.</p><p><strong>Conclusion: </strong>The concentration of and limited access to TB services at the intermediate and central levels of care indicate a need for decentralisation efforts.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10162367/pdf/i2220-8372-13-1-23.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.22.0057\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.22.0057","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Evaluating TB diagnosis and care in the Union of the Comoros.
Setting: The Union of the Comoros has experienced a persistent notification gap in TB cases despite several strategic changes, including molecular diagnosis and contact investigation. We therefore performed a TB patient pathway analysis (PPA) under the National Tuberculosis Programme (NTP).
Objective: To assess the alignment of healthcare-seeking behaviour and TB service availability to clarify the reasons for these missing cases.
Design: Three primary data sources, including a national list of health facilities, TB surveillance data and care-seeking behaviour data, were analysed at the national and regional levels to determine access to TB diagnosis and the initial point of care-seeking. Summary data were visualised using the standardised PPA Wizard programme, and the analysis was completed using demographic and socio-economic data.
Results: At the initial point of care-seeking, 18% of patients had access to TB services, available only in nine centralised public health facilities. Furthermore, 30% of patients initially consulted in the informal sector and 45% in the formal public or private sector in health facilities, both of which lacked the capacity for TB diagnosis or first-line treatment.
Conclusion: The concentration of and limited access to TB services at the intermediate and central levels of care indicate a need for decentralisation efforts.
期刊介绍:
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.