A survey of TB services in hospitals in seven large cities in Asia and North Africa.

SETTING

Hospitals in Bangkok, Cairo, Dhaka, Jakarta, Karachi, Kathmandu and Manila.

OBJECTIVES

To evaluate tuberculosis (TB) services provided in public and private hospitals in big cities.

DESIGN

A survey on TB services in hospitals was carried out in 2005 by visiting hospitals and face-to-face interviews. Selection criteria were determined for each city. All hospitals were included if feasible.

RESULTS

The number of hospitals included in the survey ranged from 52 in Bangkok to 106 in Jakarta. The proportion of private hospitals with access to a National Tuberculosis Programme (NTP) manual ranged from 8% in Jakarta to 89% in Bangkok. Private hospitals rarely functioned as a basic management unit (BMU) of the NTP, except in Bangkok. TB treatment was not always free of charge in BMU hospitals. The proportion of non-BMU hospitals that never referred/reported TB patients to the NTP was substantial in Bangkok, Dhaka, Jakarta, Karachi and Manila. Non-BMU hospitals did not routinely use standard NTP regimens, especially in Jakarta, Karachi and Manila. In non-BMU hospitals, patient tracing mechanisms were generally lacking and treatment outcome was not known.

CONCLUSION

TB services provided in non-BMU hospitals were not satisfactory. NTPs need to involve non-BMU hospitals in TB control.