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“Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic

Until 2021, in the Kyrgyz Republic, tuberculosis (TB) was diagnosed and treated only in the public sector. With funding support of the STOP–TB partnership, the private providers in four regions of the country and Bishkek city were mapped, trained and incentivized to screen for and identify presumpti...

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Autores principales: Madybaeva, Dinara, Duishekeeva, Aiymgul, Meteliuk, Anna, Kulzhabaeva, Aizat, Kadyrov, Abdullaat, Shumskaia, Natalia, Kumar, Ajay M. V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304244/
https://www.ncbi.nlm.nih.gov/pubmed/37368734
http://dx.doi.org/10.3390/tropicalmed8060316
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author Madybaeva, Dinara
Duishekeeva, Aiymgul
Meteliuk, Anna
Kulzhabaeva, Aizat
Kadyrov, Abdullaat
Shumskaia, Natalia
Kumar, Ajay M. V.
author_facet Madybaeva, Dinara
Duishekeeva, Aiymgul
Meteliuk, Anna
Kulzhabaeva, Aizat
Kadyrov, Abdullaat
Shumskaia, Natalia
Kumar, Ajay M. V.
author_sort Madybaeva, Dinara
collection PubMed
description Until 2021, in the Kyrgyz Republic, tuberculosis (TB) was diagnosed and treated only in the public sector. With funding support of the STOP–TB partnership, the private providers in four regions of the country and Bishkek city were mapped, trained and incentivized to screen for and identify presumptive TB patients and refer them to the public facilities for diagnosis and treatment. In this study, we describe the cascade of care of such patients. This was a cohort study involving secondary analysis of routine data. Of 79,352 patients screened during February 2021–March 2022, 2511 (3%) had presumptive TB, of whom 903 (36%) were not tested for TB [pre-diagnostic loss to follow-up]. A total of 323 (13%) patients were diagnosed with TB, of whom, 42 (13%) were not started on treatment [pre-treatment loss to follow-up]. Among 257 patients eligible for outcome assessment, 197 (77%) had treatment success, 29 (11%) were lost-to-follow-up, 13 (5%) died, 4 (2%) had treatment failure and 14 (5%) were not evaluated. While this donor-funded, pioneering initiative was successful in engaging the private sector, we recommend that the national TB programme scales up the initiative nationally with dedicated budgets, activities and plans to monitor progress. Qualitative research is urgently needed to understand the reasons for the gaps in the care cascade.
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spelling pubmed-103042442023-06-29 “Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic Madybaeva, Dinara Duishekeeva, Aiymgul Meteliuk, Anna Kulzhabaeva, Aizat Kadyrov, Abdullaat Shumskaia, Natalia Kumar, Ajay M. V. Trop Med Infect Dis Article Until 2021, in the Kyrgyz Republic, tuberculosis (TB) was diagnosed and treated only in the public sector. With funding support of the STOP–TB partnership, the private providers in four regions of the country and Bishkek city were mapped, trained and incentivized to screen for and identify presumptive TB patients and refer them to the public facilities for diagnosis and treatment. In this study, we describe the cascade of care of such patients. This was a cohort study involving secondary analysis of routine data. Of 79,352 patients screened during February 2021–March 2022, 2511 (3%) had presumptive TB, of whom 903 (36%) were not tested for TB [pre-diagnostic loss to follow-up]. A total of 323 (13%) patients were diagnosed with TB, of whom, 42 (13%) were not started on treatment [pre-treatment loss to follow-up]. Among 257 patients eligible for outcome assessment, 197 (77%) had treatment success, 29 (11%) were lost-to-follow-up, 13 (5%) died, 4 (2%) had treatment failure and 14 (5%) were not evaluated. While this donor-funded, pioneering initiative was successful in engaging the private sector, we recommend that the national TB programme scales up the initiative nationally with dedicated budgets, activities and plans to monitor progress. Qualitative research is urgently needed to understand the reasons for the gaps in the care cascade. MDPI 2023-06-10 /pmc/articles/PMC10304244/ /pubmed/37368734 http://dx.doi.org/10.3390/tropicalmed8060316 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Madybaeva, Dinara
Duishekeeva, Aiymgul
Meteliuk, Anna
Kulzhabaeva, Aizat
Kadyrov, Abdullaat
Shumskaia, Natalia
Kumar, Ajay M. V.
“Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic
title “Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic
title_full “Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic
title_fullStr “Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic
title_full_unstemmed “Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic
title_short “Together against Tuberculosis”: Cascade of Care of Patients Referred by the Private Health Care Providers in the Kyrgyz Republic
title_sort “together against tuberculosis”: cascade of care of patients referred by the private health care providers in the kyrgyz republic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304244/
https://www.ncbi.nlm.nih.gov/pubmed/37368734
http://dx.doi.org/10.3390/tropicalmed8060316
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