Delay and attrition before treatment initiation among MDR-TB patients in five districts of Gujarat, India

被引：16

作者：

Shewade, H. D. ^{[1
,2
]}

Shringarpure, K. S. ^{[3
]}

Parmar, M. ^{[4
]}

Patel, N. ^{[3
]}

Kuriya, S. ^{[3
]}

Shihora, S. ^{[3
]}

Ninama, N. ^{[3
]}

Gosai, N. ^{[3
]}

Khokhariya, R. ^{[3
]}

Popat, C. ^{[3
]}

Thanki, H. ^{[4
]}

Modi, B. ^{[5
]}

Dave, P. ^{[6
]}

Baxi, R. K. ^{[3
]}

Kumar, A. M. V. ^{[1
,2
]}

机构：

[1] Int Union TB & Lung Dis, South East Asia Off, New Delhi 110016, India

[2] The Union, Paris, France

[3] Med Coll, Dept Prevent & Social Med, Vadodara, India

[4] World Hlth Org Country Off India, New Delhi, India

[5] Gujarat Med Educ & Res Soc, Med Coll & Hosp, Dept Community Med, Gandhinagar, India

[6] Govt Gujarat, Dept Hlth & Family Welf, Gandhinagar, India

来源：

PUBLIC HEALTH ACTION | 2018年 / 8卷 / 02期

关键词：

multidrug-resistant tuberculosis; prevention and control; operational research; India; initial loss to follow-up;

D O I：

10.5588/pha.18.0003

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Setting: Gujarat, a state in west India. Background: Although treatment initiation has been improving among patients diagnosed with multidrug-resistant tuberculosis (MDR-TB) in programme settings, it has still not reached 100%. Objectives: To determine pre-treatment attrition (not initiated on treatment within 6 months of diagnosis), delay in treatment initiation (>7 days from diagnosis) and associated factors among MDR-TB patients diagnosed in 2014 in five selected districts served by two genotypic drug susceptibility testing (DST) facilities and a drug-resistant TB centre in Gujarat. Design: This was a retrospective cohort study involving record review. Results: Among 257 MDR-TB patients, pre-treatment attrition was seen in 20 (8%, 95% CI 5-12). Patients with 'follow-up sputum-positive' as their DST criterion and sputum smear microscopy status 'unknown' at the time of referral for DST were less likely to be initiated on treatment. The median delay to treatment initiation was 8 days (interquartile range 6-13). Patients referred for DST from medical colleges were more likely to face delays in treatment initiation. Conclusion: The Gujarat TB programme is performing well in initiating laboratory-confirmed MDR-TB patients on treatment. However, there is further scope for reducing delay.

引用

页码：59 / 65

页数：7