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私人医生及公私混合体系在发展中国家结核病检测中的作用:一项系统评价

The Role of Private Doctor and Private-Public Mix Systems in Tuberculosis Detection in Developing Countries: A Systematic Review.

作者信息

Yuliandari Rosita Dwi, Wahyuni Chatarina Umbul, Syahrul Fariani, Notobroto Hari Basuki, Qomaruddin Mochammad Bagus

机构信息

Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

出版信息

Iran J Public Health. 2025 Jun;54(6):1132-1141. doi: 10.18502/ijph.v54i6.18891.


DOI:10.18502/ijph.v54i6.18891
PMID:40655504
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12241745/
Abstract

BACKGROUND: Despite the significant efforts in tuberculosis (TB) management, TB case detection remains a challenge in developing countries. Traditional methods such as Directly Observed Treatment Short-course (DOTS) have often underperformed, necessitating the implementation of the public-private mix (PPM) strategy in recent decades. However, varied PPM models yielded varied results across different countries. Hence, this systematic review assesses the effectiveness of various PPM models and seeks innovative strategies to enhance TB detection. METHODS: A systematic search was conducted using PubMed, Scopus, Embase, and Web of Science up to August 2024. Studies evaluating the efficacy of PPM models on TB case detection in developing countries were pooled. From the initial 731 potential studies, a total of 10 studies were finally included in this systematic review. RESULTS: The review identified a variety of PPM interventions, including mass campaigns, mobile screening units, home-based tracking, and digital CXR examination. These approaches significantly raised tuberculosis detection rates compared to control groups or previous years. Notably, private sector involvement and novel approaches, such as application-based tracking in Vietnam and mobile vans equipped with digital X-rays in India, yielded favorable results. However, the variation in effectiveness rate underscored the importance of personalized approaches based on local contexts. CONCLUSION: PPM models, especially those with innovative techniques, significantly enhance TB case detection. Scaling up and modifying these strategies to various country circumstances is critical to meeting global TB reduction targets.

摘要

背景:尽管在结核病管理方面付出了巨大努力,但在发展中国家,结核病病例检测仍然是一项挑战。传统方法,如直接观察短程治疗(DOTS),往往表现不佳,因此近几十年来有必要实施公私混合(PPM)策略。然而,不同的PPM模式在不同国家产生了不同的结果。因此,本系统评价评估了各种PPM模式的有效性,并寻求创新策略以加强结核病检测。 方法:截至2024年8月,使用PubMed、Scopus、Embase和科学网进行了系统检索。汇总了评估PPM模式在发展中国家结核病病例检测中疗效的研究。从最初的731项潜在研究中,本系统评价最终共纳入了10项研究。 结果:该评价确定了多种PPM干预措施,包括大规模宣传活动、流动筛查单位、家庭追踪和数字化胸部X光检查。与对照组或前几年相比,这些方法显著提高了结核病检测率。值得注意的是,私营部门的参与和新颖方法,如越南基于应用程序的追踪以及印度配备数字X光的流动车,都取得了良好效果。然而,有效率的差异凸显了基于当地情况采取个性化方法的重要性。 结论:PPM模式,尤其是那些采用创新技术的模式,能显著提高结核病病例检测率。扩大这些策略并根据不同国家情况进行调整对于实现全球结核病减少目标至关重要。

相似文献

[1]
The Role of Private Doctor and Private-Public Mix Systems in Tuberculosis Detection in Developing Countries: A Systematic Review.

Iran J Public Health. 2025-6

[2]
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[6]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Tuberculosis care provided by private practitioners in an urban setting in Indonesia: Findings from a standardized patient study.

PLOS Glob Public Health. 2024-6-4

[2]
Exploring the Role of the Private Sector in Tuberculosis Detection and Management in Lima, Peru: A Mixed-Methods Patient Pathway Analysis.

Am J Trop Med Hyg. 2024-7-3

[3]
WHO's end of TB targets: unachievable by 2035 without addressing under nutrition, forced displacement, and homelessness: trend analysis from 2015 to 2022.

BMC Public Health. 2024-4-4

[4]
Practice regarding tuberculosis care among physicians at private facilities: A cross-sectional study from Vietnam.

PLoS One. 2023

[5]
The contribution of private health facilities to the urban tuberculosis program of Afghanistan.

Indian J Tuberc. 2023-1

[6]
WHO's Global Tuberculosis Report 2022.

Lancet Microbe. 2023-1

[7]
Integrating tuberculosis and noncommunicable diseases care in low- and middle-income countries (LMICs): A systematic review.

PLoS Med. 2022-1

[8]
Engaging Private Health Care Providers to Identify Individuals with TB in Nepal.

Int J Environ Res Public Health. 2021-11-9

[9]
Role of informal healthcare providers in tuberculosis care in low- and middle-income countries: A systematic scoping review.

PLoS One. 2021

[10]
Public-Private Mix Models of Tuberculosis Care in Pakistan: A High-Burden Country Perspective.

Front Public Health. 2021-8-10

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