MDR-TB in Puducherry, India: reduction in attrition and turnaround time in the diagnosis and treatment pathway
Objectives: Among patients with presumptive MDR-TB (July–December 2014), 1) to determine pre-diagnosis and pre-treatment attrition, 2) to determine factors associated with pre-diagnosis attrition, 3) to determine the turnaround time (TAT) from eligibility to testing and from diagnosis to treatment initiation, and 4) to compare these findings with those of the previous study (2012–2013).
Design: This was a retrospective cohort study based on record review.
Results: Compared to the previous study, there was a decrease in pre-diagnosis attrition from 45% to 24% (P < 0.001), in pre-treatment attrition from 29% to 0% (P = 0.18), in the TAT from eligibility to testing from a median of 11 days to 10 days (P = 0.89) and in the TAT from diagnosis to treatment initiation from a median of 38 days to 19 days (P = 0.04). There is further scope for reducing pre-diagnosis attrition by addressing the high risk of patients with human immunodeficiency virus and TB co-infection or those with extra-pulmonary TB not undergoing drug susceptibility testing.
Conclusion: The implementation of findings from OR resulted in improved programme outcomes.
Keywords: control; delays; diagnosis; multidrug-resistant tuberculosis; operational research; prevention
Document Type: Research Article
Affiliations: 1: International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Office, New Delhi, India 2: State TB Cell, Directorate of Health Services, Puducherry, India 3: Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India, Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India 4: Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India 5: International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Office, New Delhi, India, The Union, Paris, France 6: International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Office, New Delhi, India, Department of Community Ophthalmology, All India Institute of Medical Sciences, New Delhi, India 7: Department of Community Medicine, Employee's State Insurance Corporation Medical College, Bengaluru, India
Publication date: 21 December 2016
Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.
The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).
- Editorial Board
- Information for Authors
- International Journal of Tuberculosis and Lung Disease
- Public Health Action
- Ingenta Connect is not responsible for the content or availability of external websites
Receive new issue alert- Access Key
- Free content
- Partial Free content
- New content
- Open access content
- Partial Open access content
- Subscribed content
- Partial Subscribed content
- Free trial content