Faisal Sobia, Abbas Azadar, Haider Ghulam, Rab Azizur, Farough Khalid
Greenstar Social Marketing, Islamabad.
J Pak Med Assoc. 2018 Nov;68(11):1666-1671.
To evaluate the impact of structured engagement of private providers in tuberculosis case notification and to investigate demographic profile, disease pattern and treatment outcome of tuberculosis patients seeking care from private care providers.
This retrospective study was carried out in 13 districts of Pakistan with the data of tuberculosis patients registered and diagnosed from July 2015 to June 2016 at directly observed treatment, short-course trained private providers. These facilities in collaboration with Greenstar Social Marketing Pakistan, a private organisation and the National Tuberculosis Control Programme, Pakistan, provided free anti-tuberculosis drugs and sputum smear microscopy. Study variables included socio-demographic character, disease patterns and treatment outcomes of patients along with details of the registering facility. Data was analysed using SPSS 23.
There were 1317 directly observed treatment, short-course trained private health facilities and 123 private laboratories. Of the health facilities, 880(67%) reported 13769 tuberculosis patients. Of them, 7388(53.65%) were females and 6381(46.34%) were males. Overall, 10232(74.31%) were diagnosed with pulmonary tuberculosis and 3537(25.68%) were extra pulmonary tuberculosis patients. Among the pulmonary patients, 4195(41%) were diagnosed through sputum smear microscopy as bacteriologically confirmed (B+ve), while the remaining 6037(59%) were diagnosed through X-ray or other tests. Out of all the diagnosed patients 13218(96%) were treated successfully..
Private healthcare sector has great potential of supporting tuberculosis control. Gender and age had critical implications in service utilisation.
评估私营医疗服务提供者的结构化参与对结核病病例报告的影响，并调查向私营医疗服务提供者寻求治疗的结核病患者的人口统计学特征、疾病模式和治疗结果。
这项回顾性研究在巴基斯坦的13个地区开展，收集了2015年7月至2016年6月期间在接受过直接观察治疗短程培训的私营医疗服务提供者处登记并诊断的结核病患者的数据。这些机构与巴基斯坦的私营组织绿星社会营销公司以及巴基斯坦国家结核病控制规划合作，提供免费抗结核药物和痰涂片显微镜检查。研究变量包括患者的社会人口学特征、疾病模式和治疗结果以及登记机构的详细信息。使用SPSS 23对数据进行分析。
有1317个接受过直接观察治疗短程培训的私营医疗机构和123个私营实验室。在这些医疗机构中，880家（67%）报告了13769例结核病患者。其中，7388例（53.65%）为女性，6381例（46.34%）为男性。总体而言，10232例（74.31%）被诊断为肺结核，3537例（25.68%）为肺外结核病患者。在肺结核患者中，4195例（41%）通过痰涂片显微镜检查确诊为细菌学阳性（B+ve），其余6037例（59%）通过X线或其他检查确诊。在所有确诊患者中，13218例（96%）治疗成功。
私营医疗部门在支持结核病控制方面具有巨大潜力。性别和年龄对服务利用有至关重要的影响。
