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Treatment outcomes of mdr‐tb and referral networks in an out‐patient private‐initiated programmatic management for drug resistant tuberculosis (pmdt) facility.

Author

Victoria Dalay,
Charles Yu,
Jovilia  Abong,
Danaida Marcelo

Related Institution

De La Salle Health Sciences Institute (DLSHSI)

Publication Information

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Respirology
Frequency
Monthly
Publication Date
November 2017
Volume
22
Issue
3
Page(s)
62

Abstract

BACKGROUND AND AIMS:
A private‐initiated Programmatic Management for Drug Resistant Tuberculosis (PMDT) facility located in an urban community in Cavite, Philippines has been recognized by the Regional Health Office for its contribution to MDRTB detection and treatment. This study evaluated the treatment management and referral networks of this facility to determine best practices for improving MDRTB diagnostic and treatment outcomes.


METHODS:
The presumptive MDRTB masterlist, registry, individual records were reviewed for characteristics, treatment outcome of 2015 cohort. The sources of referral were also reviewed from the 2016 records of presumptive MDRTB patients.


RESULTS:
In 2015, 160 (84.2%) of the 190 diagnosed MDRTB were enrolled for treatment in this private initiated PMDT facility. The average turnaround time for enrolment is 25.9 days. The reasons for non‐enrollment were illness denial, death, preference for other treatment facility. Among the enrolled, 90% were more than 15 y.o., 24% were diabetics, while one was HIV (+). Among those with known treatment outcome after 18 months, 38.6 % (41/106) had successful outcome. 53% (53/106) were lost to ff‐up, 9.4% (10/106) died, and 1.9% (2/106) failed. Reasons for those who lost to follow‐ups include family concerns (35%), financial constraints (7.5%), adverse drug events (6%), co‐morbidities (3%), relocation (2.5%), conflict with work/school (2.5%). Fifty‐six (35%) had extended treatment beyond 18 months due to frequently missing doses. Review of 2016 reports showed that majority (73%) of referrals came from public facilities. Only 12% and 8% of referrals came from the hospitals and private physicians, respectively.


CONCLUSIONS:
In spite of good and excellent services offered by the facility, high rate of lost to follow‐up were reported. One third of the cases extended the treatment beyond 18 months. Interventions must be done to increase the treatment success rate. Majority of detected DRTB cases were referred from the nearby public health centers.

Physical Location

LocationLocation CodeAvailable FormatAvailability
De La Salle Health Sciences Institute Abstract

 
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