Estimating the magnitude of pulmonary tuberculosis patients missed by primary health care clinics in South Africa

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
P F KwezaA Medina-Marino

Abstract

The present study was conducted at 20 randomly selected primary health clinics across Buffalo City Metropolitan Health District, a high TB burden district in South Africa. To estimate the proportion of TB patients missed by primary health clinics. We enrolled 1255 TB-symptomatic individuals exiting primary health clinics between March and December 2015. Participants were interviewed and asked to provide sputum for Xpert® MTB/RIF testing. Clinic staff screened 79.1% of participants seeking care for TB-related symptoms and 21.9% of those attending a clinic for other reasons (P < 0.001). Of those screened by clinic staff, 21.5% reported submitting sputum, although only 9.8% had available results. Study staff tested sputum from 779 participants not tested by clinic staff. Of these, 39 (5.0%) individuals tested positive for TB, three of whom were rifampicin-resistant; 15/39 (38.5%) were never screened and 24/39 (61.5%) were screened but not tested by clinic staff. We estimate that the health system missed 62.9-78.5% of TB patients attending primary health clinics for TB-related symptoms and 89.5-100% of those attending a clinic for other reasons. Low rates of TB screening and testing by the health system resulted in missed TB patien...Continue Reading

Citations

Mar 17, 2019·Tropical Medicine and Infectious Disease·Anthony D HarriesRony Zachariah
Feb 26, 2019·BMJ Global Health·Nesri PadayatchiMadhukar Pai
Aug 25, 2020·Transactions of the Royal Society of Tropical Medicine and Hygiene·Joyce B DerAlison D Grant
Oct 9, 2019·The Journal of Infectious Diseases·Ruvandhi R NathavitharanaSamuel G Schumacher
Dec 12, 2020·International Journal for Equity in Health·Charity Oga-OmenkaChristina Zarowsky
Mar 25, 2021·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Frauke RudolfChristian Wejse
Apr 19, 2021·BMC Health Services Research·Keith Twirire KakameSebastian Olikira Baine
Aug 28, 2021·The Lancet. Digital Health·Christine Tzelios, Ruvandhi R Nathavitharana
Jul 28, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nishila MoodleySalome Charalambous
Dec 6, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Indira GovenderUNKNOWN Vukuzazi study teams

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