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Access to quality diagnosis and rational treatment for tuberculosis: real-world evidence from China–Gates Tuberculosis Control Project Phase III
- Source :
- Infectious Diseases of Poverty, Vol 10, Iss 1, Pp 1-12 (2021), Infectious Diseases of Poverty
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background China has successfully reduced tuberculosis (TB) incidence rate over the past three decades, however, challenges remain in improving the quality of TB diagnosis and treatment. In this paper, we assess the effects of the implementation of “China National Health Commission (NHC) and Gates Foundation TB Prevention and Control Project” on the quality of TB care in the three provinces. Methods We conducted the baseline study in 2016 and the final evaluations in 2019 in the 12 selected project counties. We obtained TB patients’ information from the TB Information Management System and reviewed medical records of TB cases in the TB designated hospitals. We compared TB diagnosis and treatment services with the national practice guideline and used Student’s t-test and Pearson χ2 tests or Fisher’s exact tests to compare the difference before and after the project implementation. Results The percentage of sputum smear-negative (SS–) patients taking culture or rapid molecular test (RMT) doubled between 2015 and 2018 (from 35% to 87%), and the percentage of bacteriologically confirmed pulmonary TB cases increased from 36% to 52%. RMT has been widely used and contributed an additional 20% of bacteriologically confirmed TB cases in 2018. The percentage of TB patients taking drug susceptibility tests (DST) also doubled (from 40% in 2015 to 82% in 2018), and the proportion of TB patients receiving adequate diagnosis services increased from 85% to 96%. Among all SS– TB patients, over 86% received the recommended diagnostic services at the end of the study period, an improvement from 75% prior to the project implementation. However, the proportion of TB patients treated irrationally using second-line anti-TB drugs (SLDs) increased from 12.6% in 2015 to 19.9% in 2018. The regional disparities remained within the project provinces, albeit the gaps between them narrowed down for almost all indicators. Conclusions The quality of TB diagnosis services has been improved substantially, which is attributable to the coverage of new diagnosis technology. However, irrational use of SLDs remains a concern after the project implementation. Graphic abstract
- Subjects :
- Pediatrics
medicine.medical_specialty
China
Tuberculosis
Antitubercular Agents
Infectious and parasitic diseases
RC109-216
030204 cardiovascular system & hematology
Real world evidence
03 medical and health sciences
0302 clinical medicine
Diagnosis
medicine
Humans
030212 general & internal medicine
Second line drugs
Evaluation
Tuberculosis, Pulmonary
business.industry
Public health
Medical record
Public Health, Environmental and Occupational Health
Sputum
General Medicine
Guideline
medicine.disease
Treatment
Rapid molecular test
Infectious Diseases
Tropical medicine
Tuberculosis control
medicine.symptom
Public aspects of medicine
RA1-1270
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 20499957
- Volume :
- 10
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Infectious Diseases of Poverty
- Accession number :
- edsair.doi.dedup.....429a8781979bb14e154f31ba2253571a