“DOST” Model to Link and Support Drug Resistant TB Patients From Private Sector: An Experience From Delhi, India

Vatsyayan, Vindhya; Pattery, Theresa; Sayyad, Khasim; Williams, Jason; Pal, Arnab; Panibatla, Vikas; Khanna, Ashwani

doi:10.3389/fpubh.2022.835055

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…Currently, models to engage private doctors in diagnostic services are limited. One recent example is of the “DOST” intervention model, where 9331 specimens from private doctors/facilities were transported by an interface agency to Xpert sites at public facilities between July 2019 and December 2020 [ 11 ]. In this model, only 68% of the specimens completed the LPA tests.…”

Section: Discussionmentioning

confidence: 99%

Private Doctors’ Perspective towards “Patient First” in TB Diagnostic Cascade, Hisar, India

Saini,

Prasad,

Mahajan

et al. 2024

Diagnostics

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TB diagnosis has been simplified in India following advances in available diagnostic tools. This facilitates private doctors’ “patient first” approach toward early diagnosis; however, costs remain high. India’s NTEP established a TB diagnostic network, which is free for patients and incentivizes private doctors to participate. Drawing from this context led to the design and implementation of the One-Stop TB Diagnostic Solution model, which was conducted in the Hisar district, Haryana, allowing specimens from presumptive TB patients from private doctors to be collected and tested as per NTEPs diagnostic algorithm. A subset of data pertaining to private doctors was analyzed for the project period. Qualitative data were also collected by interviewing doctors using a snowball method to capture doctors’ perception about the model. Out of 1159 specimens collected from 60 facilities, MTB was detected in 32% and rifampicin resistance was detected in 7% specimens. All specimens went through the diagnostic algorithm. Thirty doctors interviewed were satisfied with the services offered and were appreciative of the program that implements this “patient centric” model. Results from implementation indicate the need to strengthen private diagnostics through a certification process to ensure provision of quality TB diagnostic services.

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Section: Discussionmentioning

confidence: 99%

Private Doctors’ Perspective towards “Patient First” in TB Diagnostic Cascade, Hisar, India

Saini,

Prasad,

Mahajan

et al. 2024

Diagnostics

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“…Comparing these results with the Hisar model, 99% of specimens with RS and 98% RR completed the diagnostic algorithm (a comparative table with the model is available in Supplementary Tables S1 and S2). The "DOST" intervention model in Delhi was designed to strengthen the patient care pathway, collected 9331 specimens of patients from private providers, and transported them to Xpert sites in public facilities through an interface agency [13]. The Xpert results showed 382 specimens were RR and 198 (52%) specimens were subjected to SL-LPA, out of which 134 (68%) completed the tests.…”

Section: Discussionmentioning

confidence: 99%

“…India is one of the high TB burden countries and has committed to ending TB by 2025 through strategies envisaged in the "National Strategic Plan" with a focus on building and strengthening the health system for early detection and appropriate treatment [2]. Early detection through high-sensitivity diagnostics and universal access Diagnostics 2023, 13, 2823 2 of 11 to quality TB diagnosis is one of the key priority areas. The diagnostic network under the National TB Elimination Program (NTEP) has expanded, with molecular diagnostics at districts and sub-district level (5090 sites with Xpert/Truenat) and TB culture and drug-susceptibility testing facilities (83 Culture and Drug Susceptibility Testing (DST), 34 intermediate reference laboratories) with cutting-edge technologies at state and national levels (six national reference laboratories) [3].…”

Section: Introductionmentioning

confidence: 99%

Experience of “One Stop TB Diagnostic Solution” Model in Engaging a Private Laboratory for End-to-End Diagnostic Services in the National TB Elimination Program in Hisar, India

Raju,

Prasad,

Alavadi

et al. 2023

Diagnostics

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The complete diagnostic evaluation of tuberculosis based on its drug-resistance profile is critical for appropriate treatment decisions. The TB diagnostic landscape in India has been transformed with the scaling-up of WHO-recommended diagnostics, but challenges remain with specimen transportation, completing diagnostic assessment, turnaround time (TAT), and maintaining laboratories. Private laboratories have demonstrated efficiencies for specimen collection, transportation, and the timely testing and issue of results. A one-stop TB diagnostic model was designed to assess the feasibility of providing end-to-end diagnostic services in the Hisar district of Haryana state, India. A NTEP-certified private laboratory was engaged to provide the services, complementing the existing public sector diagnostic services. A total of 10,164 specimens were collected between May 2022 and January 2023 and these were followed for the complete diagnostic assessment of Drug-Susceptible TB (DS-TB) and Drug-Resistant TB (DR-TB) and the time taken for issuing results. A total of 2152 (21%) patients were detected with TB, 1996 (93%) Rifampicin-Sensitive and 134 (6%) with Rifampicin-Resistant TB. Nearly 99% of the patients completed the evaluation of DS-TB and DR-TB within the recommended TAT. The One-Stop TB/DR-TB Diagnostic Solution model has demonstrated that diagnostic efficiencies could be enhanced through the strategic purchase of private laboratory services.

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“…The NTEP in collaboration with TBAI and CHAI had implemented a collaborative project to strengthen the network between the private practitioners and public healthcare facilities in New Delhi during 2019 and 2020. It was referred to as "DOST" model to link and support DR-TB patients from private sector [6].…”

Section: Introductionmentioning

confidence: 99%

“…The project staff accompanied the patients to the appropriate health facilities and ensured that all the patients undergo appropriate diagnostic tests and are initiated on treatment in a timely manner. The authors have published the process of DR-TB care services provided under the project elsewhere and it essentially included prompt identification of presumptive DR-TB patients, sample collection and transportation, testing and reporting, conduct of pre-treatment evaluation, ambulatory care of DR-TB patients, regular follow-up, and screening of family members [6]. Under this project, about 9331 private sector patients were subjected to cartridge based nucleic acid amplification test (CBNAAT), 382 (4%) patients were diagnosed with DR-TB, 301 (79%) were linked to NTEP Delhi and V. Vatsyayan et al 231 (76%) patients were initiated on treatment in the public sector.…”

Section: Introductionmentioning

confidence: 99%

DOST Model’ for DR-TB Patients, New Delhi: Perspectives of Healthcare Providers

Vatsyayan¹,

Pattery²,

Sayyad³

et al. 2022

JTR

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Introduction: In India, tuberculosis continues to be a major public health problem and there is a growing concern about drug-resistant tuberculosis as most of the patients are from private sector. The National TB Elimination Programme (NTEP) in collaboration with TB Alert, India (TBAI) and Clinton Health Association of India (CHAI) had implemented a collaborative project to strengthen the network between the private practitioners and public healthcare facilities in New Delhi during 2019 and 2020. Methods: A study was conducted to understand the enablers and challenges encountered by them during the implementation of the project. This is a qualitative exploration of the "healthcare providers" on a project linking DR-TB patients in private sector with government health facilities. The process of data collection involved face-to-face in-depth interviews of healthcare providers, the Doctors mainly from private and public health facilities, the paramedical workers from general health system and paramedical from the project using an interview guide administered through a trained researcher. Results: The study findings revealed that all healthcare providers were completely aware of the DOST project in the health system, the model led to early diagnosis and initiation of quality treatment. There were no major challenges to the implementation of the project. The healthcare providers wish to have this project implemented for a longer duration. Conclusion: The perspectives of healthcare providers towards the "DOST" project were optimistic and call for re-initiating the project in the area.

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“DOST” Model to Link and Support Drug Resistant TB Patients From Private Sector: An Experience From Delhi, India

Cited by 3 publications

References 2 publications

Private Doctors’ Perspective towards “Patient First” in TB Diagnostic Cascade, Hisar, India

Private Doctors’ Perspective towards “Patient First” in TB Diagnostic Cascade, Hisar, India

Experience of “One Stop TB Diagnostic Solution” Model in Engaging a Private Laboratory for End-to-End Diagnostic Services in the National TB Elimination Program in Hisar, India

DOST Model’ for DR-TB Patients, New Delhi: Perspectives of Healthcare Providers

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