Cargando…
Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system
BACKGROUND: Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilit...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425571/ https://www.ncbi.nlm.nih.gov/pubmed/32787869 http://dx.doi.org/10.1186/s12879-020-05298-8 |
_version_ | 1783570523789197312 |
---|---|
author | Doulla, Basra Esmail Squire, Stephen Bertel MacPherson, Eleanor Ngadaya, Esther Stanslaus Mutayoba, Beatrice Kemilembe Langley, Ivor |
author_facet | Doulla, Basra Esmail Squire, Stephen Bertel MacPherson, Eleanor Ngadaya, Esther Stanslaus Mutayoba, Beatrice Kemilembe Langley, Ivor |
author_sort | Doulla, Basra Esmail |
collection | PubMed |
description | BACKGROUND: Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilities to reference laboratory and results dissemination back to the health facilities, result in poor patient management, particularly where multidrug-resistant tuberculosis disease is present. METHODS: Following a detailed qualitative study, a pilot intervention of a revised Tuberculosis Routine Surveillance System was implemented in Mwanza region, Tanzania. This included the use of rapid molecular methods for the detection of both tuberculosis and drug resistance using Xpert MTB/RIF in some Mwanza sites, the use of Xpert MTB/RIF and Line Probe Assay at the Central Tuberculosis Reference Laboratory, a revised communication strategy and interventions to address the issue of poor form completion. A before and after comparison of the intervention on the number of drug resistant tuberculosis cases identified and the time taken for results feedback to the requesting site was reported. RESULTS: The revised system for previously treated cases tested at the Central Reference Laboratory was able to obtain the following findings; the number of cases tested increased from 75 in 2016 to 185 in 2017. The times for specimen transportation from health facilities to the reference laboratory were reduced by 22% (from 9 to 7 days). The median time for the district to receive results was reduced by 36% (from 11 to 7 days). Overall the number of drug resistant tuberculosis cases starting treatment increased by 67% (from 12 to 20). CONCLUSION: Detection of drug resistance could significantly be enhanced, and delays reduced by introduction of new technologies and improved routine surveillance system, including better communication using mobile applications such as ‘WhatsApp’ and close follow-ups. A larger scale study is now merited to ascertain if these benefits are robust across different contexts. |
format | Online Article Text |
id | pubmed-7425571 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74255712020-08-16 Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system Doulla, Basra Esmail Squire, Stephen Bertel MacPherson, Eleanor Ngadaya, Esther Stanslaus Mutayoba, Beatrice Kemilembe Langley, Ivor BMC Infect Dis Research Article BACKGROUND: Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilities to reference laboratory and results dissemination back to the health facilities, result in poor patient management, particularly where multidrug-resistant tuberculosis disease is present. METHODS: Following a detailed qualitative study, a pilot intervention of a revised Tuberculosis Routine Surveillance System was implemented in Mwanza region, Tanzania. This included the use of rapid molecular methods for the detection of both tuberculosis and drug resistance using Xpert MTB/RIF in some Mwanza sites, the use of Xpert MTB/RIF and Line Probe Assay at the Central Tuberculosis Reference Laboratory, a revised communication strategy and interventions to address the issue of poor form completion. A before and after comparison of the intervention on the number of drug resistant tuberculosis cases identified and the time taken for results feedback to the requesting site was reported. RESULTS: The revised system for previously treated cases tested at the Central Reference Laboratory was able to obtain the following findings; the number of cases tested increased from 75 in 2016 to 185 in 2017. The times for specimen transportation from health facilities to the reference laboratory were reduced by 22% (from 9 to 7 days). The median time for the district to receive results was reduced by 36% (from 11 to 7 days). Overall the number of drug resistant tuberculosis cases starting treatment increased by 67% (from 12 to 20). CONCLUSION: Detection of drug resistance could significantly be enhanced, and delays reduced by introduction of new technologies and improved routine surveillance system, including better communication using mobile applications such as ‘WhatsApp’ and close follow-ups. A larger scale study is now merited to ascertain if these benefits are robust across different contexts. BioMed Central 2020-08-12 /pmc/articles/PMC7425571/ /pubmed/32787869 http://dx.doi.org/10.1186/s12879-020-05298-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Doulla, Basra Esmail Squire, Stephen Bertel MacPherson, Eleanor Ngadaya, Esther Stanslaus Mutayoba, Beatrice Kemilembe Langley, Ivor Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title | Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_full | Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_fullStr | Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_full_unstemmed | Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_short | Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
title_sort | reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425571/ https://www.ncbi.nlm.nih.gov/pubmed/32787869 http://dx.doi.org/10.1186/s12879-020-05298-8 |
work_keys_str_mv | AT doullabasraesmail reducingdelaystomultidrugresistanttuberculosiscasedetectionthrougharevisedroutinesurveillancesystem AT squirestephenbertel reducingdelaystomultidrugresistanttuberculosiscasedetectionthrougharevisedroutinesurveillancesystem AT macphersoneleanor reducingdelaystomultidrugresistanttuberculosiscasedetectionthrougharevisedroutinesurveillancesystem AT ngadayaestherstanslaus reducingdelaystomultidrugresistanttuberculosiscasedetectionthrougharevisedroutinesurveillancesystem AT mutayobabeatricekemilembe reducingdelaystomultidrugresistanttuberculosiscasedetectionthrougharevisedroutinesurveillancesystem AT langleyivor reducingdelaystomultidrugresistanttuberculosiscasedetectionthrougharevisedroutinesurveillancesystem |