Madybaeva Dinara, Duishekeeva Aiymgul, Meteliuk Anna, Kulzhabaeva Aizat, Kadyrov Abdullaat, Shumskaia Natalia, Kumar Ajay M V
Public Foundation "AFEW KG", 14 JalArtis, 103, Bishkek 720047, Kyrgyzstan.
Public Foundation "KNCV KG", 121 Dzhantoshev St., Bishkek 720020, Kyrgyzstan.
Trop Med Infect Dis. 2023 Jun 10;8(6):316. doi: 10.3390/tropicalmed8060316.
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.
直到2021年，在吉尔吉斯共和国，结核病仅在公共部门进行诊断和治疗。在抗击结核病伙伴关系的资金支持下，对该国四个地区和比什凯克市的私立医疗服务提供者进行了排查、培训并给予激励，以筛查和识别疑似结核病患者，并将他们转诊至公共医疗机构进行诊断和治疗。在本研究中，我们描述了这类患者的医疗照护流程。这是一项涉及常规数据二次分析的队列研究。在2021年2月至2022年3月期间筛查的79352名患者中，有2511名（3%）为疑似结核病患者，其中903名（36%）未接受结核病检测[诊断前失访]。共有323名（13%）患者被诊断为结核病，其中42名（13%）未开始治疗[治疗前失访]。在257名符合结局评估条件的患者中，197名（77%）治疗成功，29名（11%）失访，13名（5%）死亡，4名（2%）治疗失败，14名（5%）未进行评估。虽然这项由捐助者资助的开创性举措成功地让私立医疗部门参与进来，但我们建议国家结核病规划在全国范围内扩大该举措，并配备专门的预算、活动和计划以监测进展情况。迫切需要开展定性研究以了解医疗照护流程中出现差距的原因。
