Evaluation of outcomes of tuberculosis management in private for profit and private-not-for profit directly observed treatment short course facilities in Lagos State, Nigeria

Adejumo, Olusola Adedeji; Daniel, Olusoji; Otesanya, Andrew Folarin; Salisu-Olatunj, Shukrat Olajumoke; Abdur-Razzaq, Husseine A

doi:10.4103/0300-1652.218417

Cited by 14 publications

(19 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Structures facilitating TB/HIV collaboration exist at all levels [3, 32], but integration is weak [28, 30]. Public-private partnership improved TB case detection and case holding [31, 33–36]. Existence of evidence-informed guidelines and a steering committee [28]; capacity building, stakeholders meeting and quarterly supervision [32] enabled engagement of the private sector in TB control.…”

Section: Resultsmentioning

confidence: 99%

Governance of tuberculosis control programme in Nigeria

Ogbuabor

Onwujekwe

2019

Infect Dis Poverty

View full text Add to dashboard Cite

Background The role of governance in strengthening tuberculosis (TB) control has received little research attention. This review provides evidence of how institutional designs and organisational practices influence implementation of the national TB control programme (NTP) in Nigeria. Main text We conducted a scoping review using a five-stage framework to review published and grey literature in English, on implementation of Nigeria’s NTP and identified themes related to governance using a health system governance framework. We included articles, of all study designs and methods, which described or analysed the processes of implementing TB control based on relevance to the research question. The review shows a dearth of studies which examined the role of governance in TB control in Nigeria. Although costed plans and policy coordination framework exist, public spending on TB control is low. While stakeholders’ involvement in TB control is increasing, institutional capacity is limited, especially in the private sector. TB-specific legislation is absent. Deployment and transfer of staff to the NTP are not transparent. Health workers are not transparent in communicating service entitlements to users. Despite existence of supportive policies, integration of TB control into the community and general health services have been weak. Willingness to pay for TB services is high, however, transaction cost and stigma among patients limit equity. Effectiveness and efficiency of the NTP was hindered by inadequate human resources, dilapidated service delivery infrastructure and weak drug supply system. Despite adhering to standardized recording and reporting format, regular monitoring and evaluation, revision of reporting formats, and electronic data management system, TB surveillance system was found to be weak. Delay in TB diagnosis and initiation of care, poor staff attitude to patients, lack of privacy, poor management of drug reactions and absence of infection control measures breach ethical standards for TB care. Conclusions This scoping review of governance of TB control in Nigeria highlights two main issues. Governance for strengthening TB control programmes in low-resource, high TB burden settings like Nigeria, is imperative. Secondly, there is a need for empirical studies involving detailed analysis of different dimensions of governance of TB control. Electronic supplementary material The online version of this article (10.1186/s40249-019-0556-2) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Governance of tuberculosis control programme in Nigeria

Ogbuabor

Onwujekwe

2019

Infect Dis Poverty

View full text Add to dashboard Cite

show abstract

“…In Myanmar, patients treated by private practitioners were more likely to be LTFU [86]. An interesting situation was observed in Nigeria where patients treated at private, not-for-profit (PNFP) DOT facilities were more likely to be LTFU [87]. The researchers concluded that "Patients managed at PFP [private, for-profit] DOT facilities were probably richer, had better education, nutrition, and knowledge of TB than patients managed at PNFP DOT facilities…" Indeed, the factors causing LTFU are not simple, and they are correlated with each other.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Loss to Follow-Up (LTFU) during Tuberculosis Treatment

Lin¹

2019

Healthcare Access - Regional Overviews [Working Title]

View full text Add to dashboard Cite

Loss to follow-up (LTFU) is a serious issue in the field of tuberculosis (TB) since it can lead to TB outbreaks and drug resistance. The proportion of LTFU patients differs among different countries, regions, year, and institutions. In some countries, the number of patients that were LTFU nearly reaches half of the total patients. Underlying factors such as age, gender, education, residence, financial factors, migration, and social stigma are discussed in this chapter. These factors should always be taken into consideration whenever a treatment program is designed. Suggestions have been made regarding some interventions that could potentially solve the problem of LTFU. With these points in mind, an ambitious approach should be taken to reduce the number of LTFU patients up to zero.

show abstract

“…Despite the relatively high reported overall national TSR over the years, DRTB case notification in Nigeria has increased from 21 in 2010 to 1,686 in 2016 and a further increase of 35% from 1,686 in 2016 to 2,286 in 2017 [ 2 ]. In addition, a WHO survey in Mexico showed that one-third of patients who died from TB were managed by private practitioners [ 20 ]. TSR data disaggregated by type of facility (public versus private) is lacking in Nigeria, making efforts to monitor the success of recent DOTS program expanded into private facilities difficult.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes of drug susceptible Tuberculosis in private health facilities in Lagos, South-West Nigeria

et al. 2021

View full text Add to dashboard Cite

Background The Lagos State Tuberculosis, Buruli Ulcer, and Leprosy Control Program (LSTBLCP) started engaging private hospitals under the Public-Private Mix (PPM) Program in 2008. The study aimed to evaluate the trend and predictors of successful Tuberculosis (TB) treatment outcomes of patients managed across these private health facilities between 2010–2016 in Lagos, Nigeria. Methods Retrospective review of TB treatment register and treatment cards of patients commenced on TB treatment between January 2010 and December 2016 in 36 private health facilities engaged by the LSTBLCP. Between December 2016 and February 2017, data were collected and entered into Microsoft Excel by trained data entry clerks. The analysis was done using SPSS software. Independent predictors of successful treatment outcomes were determined using multivariate analysis at the statistical significance of p<0.05 and 95% confidence interval. Results A total of 1660 records of TB patients were reviewed. 1535 (92.47%) commenced treatment, while 1337 (87.10%) of all records had documented treatment outcomes. Of the 1337 patients with outcomes, 1044 (78.09%) had a successful treatment outcome, and 293 (21.91%) had an unsuccessful outcome. Majority were male, 980 (59.04%), Human Immunodeficiency Virus (HIV) negative status, 1295 (80.24%), diagnosed with smear, 1141 (73.14%), treated in private not-for-profit (PNFP) hospital, 1097 (66.08%), treated for TB between 2014–2016 (18.96%-19.52%). In multivariate analysis, age>20years (aOR = 0.26, p = 0.001), receiving TB treatment in 2013 (aOR = 0.39, p = 0.001), having genexpert for TB diagnosis (aOR = 0.26, p = 0.031) and being HIV positive (aOR = 0.37, p = 0.001) significantly reduced likelihood of successful treatment outcome. The site of TB, being on ART or CPT, were confounding determinants of successful treatment outcomes as they became non-significant at the multivariate analysis level. Conclusion Treatment outcome among Lagos private hospitals was low compared with NTBLCP and World Health Organization (WHO) target. We urge the government and TB stakeholders to strengthen the PPM interventions to improve adherence, particularly among People Living with HIV (PLHIV) and older TB patients. Hence, promotion of early care-seeking, improving diagnostic and case holding efficiencies of health facilities, and TB/HIV collaborative interventions can reduce the risk of an unsuccessful outcome.

show abstract

Evaluation of outcomes of tuberculosis management in private for profit and private-not-for profit directly observed treatment short course facilities in Lagos State, Nigeria

Cited by 14 publications

References 20 publications

Governance of tuberculosis control programme in Nigeria

Governance of tuberculosis control programme in Nigeria

Loss to Follow-Up (LTFU) during Tuberculosis Treatment

Treatment outcomes of drug susceptible Tuberculosis in private health facilities in Lagos, South-West Nigeria

Contact Info

Product

Resources

About