Department of Health Economics, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India.
Department of Statistics, Epidemiology Unit, Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India.
Trop Med Int Health. 2020 May;25(5):612-617. doi: 10.1111/tmi.13380. Epub 2020 Feb 28.
To discern and quantify the TB diagnostic cascade among patients registered under the Revised National TB Control Programme, Chennai city, Tamil Nadu, South India.
This cross-sectional study was conducted in metropolitan Chennai from February 2017 to March 2018. We interviewed TB patients retrospectively on their diagnostic attempt in different health facilities.
Of 455 TB patients, only 4.4% received their diagnosis at their first health facility. Of 1250 visits to health facilities, the vast majority (79.4 vs. 20.6%) was in the public rather than the private sector. 56% of patients went to a public facility as the first point of care, of whom 1.6% shifted to private facilities subsequently. The remaining 54.4% shifted between up to five government health facilities. Male patients and those with a higher family income were more likely to shift from private to public.
Most shifts between diagnostic facilities occurred in the public sector. This necessitates interventions at public health facilities for strengthening and extending services to TB patients at their first point of care.
在印度南部泰米尔纳德邦钦奈市的修订国家结核病控制规划登记的患者中，识别和量化结核病诊断环节。
这项横断面研究于 2017 年 2 月至 2018 年 3 月在钦奈大都市区进行。我们对结核病患者进行了回顾性访谈，了解他们在不同医疗机构的诊断尝试情况。
在 455 名结核病患者中，只有 4.4%在其第一家医疗机构得到诊断。在 1250 次就诊中，绝大多数（79.4%比 20.6%）是在公共部门而不是私营部门。56%的患者首先去了公共医疗机构就诊，其中 1.6%随后转到了私营医疗机构。其余 54.4%的患者在最多五家政府医疗机构之间进行了转移。男性患者和家庭收入较高的患者更有可能从私人部门转移到公共部门。
大多数诊断机构之间的转移都发生在公共部门。这需要在公共卫生机构采取干预措施，为首次就诊的结核病患者加强和扩展服务。
