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Drug-resistant tuberculosis patient care journeys in South Africa: a pilot study using routine laboratory data.
- Source :
-
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease [Int J Tuberc Lung Dis] 2020 Jan 01; Vol. 24 (1), pp. 83-91. - Publication Year :
- 2020
-
Abstract
- SETTING: Thirteen districts in Eastern Cape (EC), KwaZulu-Natal (KZN) and Western Cape (WC) Provinces, South Africa. OBJECTIVE: To pilot a methodology for describing and visualising healthcare journeys among drug-resistant tuberculosis (DR-TB) patients using routine laboratory records. DESIGN: Laboratory records were obtained for 195 patients with laboratory-detected rifampicin-resistant TB (RR-TB) during July-September 2016. Health facility visits identified from these data were plotted to visualise patient healthcare journeys. Data were verified by facility visits. RESULTS: In the 9 months after the index RR-TB sample was collected, patients visited a mean of 2.3 health facilities (95% CI 2.1-2.6), with 9% visiting ≥4 facilities. The median distance travelled by patients from rural areas (116 km, interquartile range [IQR] 50-290) was greater than for urban patients (51 km, IQR 9-140). A median of 21% of patient's time was spent under the care of primary healthcare facilities: this was respectively 6%, 37% and 39% in KZN, EC and WC. Journey patterns were generally similar within districts. Some reflected a semi-centralised model of care where patients were referred to regional hospitals; other journeys showed greater involvement of primary care. CONCLUSION: Routine laboratory data can be used to explore DR-TB patient healthcare journeys and show how the use of healthcare services for DR-TB varies in different settings.
Details
- Language :
- English
- ISSN :
- 1815-7920
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
- Publication Type :
- Academic Journal
- Accession number :
- 32005310
- Full Text :
- https://doi.org/10.5588/ijtld.19.0100