355Tuberculosis care cascade in an indigenous population of a Colombian region.

Background It is estimated, there are around 370 million indigenous people in the world. For 2017, 5.4% of tuberculosis cases in Colombia occurred in the indigenous population (IP), while in the Cauca region, it was 32% and only 19.3% of new cases were detected. This is the second region with the highest proportion of IP in Colombia. This could affect the fulfillment of the aims of the Colombian Strategic Plan Towards the End of TB. Our aim was to evaluate the pulmonary tuberculosis (PTB) care cascade in IP of Cauca and identified gaps in the cascade. Methods Mixed methods (explanatory sequential desing). In the quantitative phase, the care cascade was evaluated. In the qualitative phase we sought to explain the gaps in the cascade. Tuberculosis program information and semi-structured interviews were used. Results In the care cascade in IP, 202 cases of presumptive PTB (New smear-positive expected) were estimated. A gap of undiagnosed cases of 47.5% was found (n = 96). This gap was explained by poor quality of the Acid-Fast Bacillus Smear, failures in the identification of presumptive tuberculosis, limited access to diagnostic methods, poor training and high turnover of healthcare workers were identified as possible explanations. Conclusions The efforts of the tuberculosis control program in the IP should focus on reducing the gap of undiagnosed cases. Key messages The PTB in IP could affect the fulfillment of the goals of the program. Approximately half of the expected cases were not detected during 2016-2017. [ABSTRACT FROM AUTHOR]