Default during TB diagnosis: quantifying the problem

Authors: Khan, Mishal S.1; Khan, Shoaib2; Godfrey-Faussett, Peter1

Source: Tropical Medicine & International Health, Volume 14, Number 12, December 2009 , pp. 1437-1441(5)

Publisher: Blackwell Publishing

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Abstract:

Summary Objectives 

To quantify default during diagnosis in TB suspects and in smear-positive cases; to investigate sex differences in default during diagnosis, in all of Pakistan. Methods 

Data from laboratory registers were collected on 12 216 suspects in nine districts over the period July-September 2008. Results 

A total of 1573 TB suspects (12.9%, 95% CI = 12.3-13.5) dropped out of the diagnostic process after initial sputum submission. A total of 2058 smear-positive cases were detected, and of these 107 (5.2%, 95% CI = 4.2-6.2) defaulted during diagnosis and therefore could not be started on treatment. Male suspects defaulted slightly more frequently than female suspects (P =0.0268). Conclusion 

Default during diagnosis is a frequent occurrence in Pakistan that should be monitored and addressed by TB control programs.

French
<title>Désistement lors du diagnostic de la tuberculose: quantifier le problème</title> Objectifs: 

Quantifier le désistement lors du diagnostic chez les cas suspects de tuberculose (TB) et chez les cas à frottis positif, investiguer les différences entre sexes dans le désistement lors du diagnostic dans tous le Pakistan. Méthode: 

Les données sur 12216 suspects ont été collectées des registres de laboratoire dans 9 districts durant la période de juillet à septembre 2008. Résultats: 

1573 suspects TB (12,9%; IC95%: 12,3 - 13,5) ont abandonné le processus de diagnostic après la première soumission de crachat. 2058 cas à frottis positif ont été détectés dont 107 (5,2%, IC95%: 4,2 - 6,2) ont désisté lors du diagnostic, ne pouvant dès lors pas être mis sous traitement. Les suspects masculins désistaient un peu plus fréquemment que les suspects féminins (p = 0,0268). Conclusion: 

Le désistement lors du diagnostic est un phénomène fréquent au Pakistan qui devrait être suivi et adressé par les programmes de lutte antituberculeuse.

Keywords: tuberculosis; diagnosis; case finding; quantitative; tuberculose; diagnostic; dépistage des cas; quantitative; Tuberculosis; diagnóstico; búsqueda de casos; cuantitativo

Document Type: Short communication

DOI: 10.1111/j.1365-3156.2009.02406.x

Affiliations: 1:  London School of Hygiene and Tropical Medicine, London, UK 2:  Aga Khan University Hospital, Karachi, Pakistan

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