Reasons for the low bacteriological coverage of tuberculosis reported in Mpumalanga Province, South Africa

Mngomezulu, Nonhlanhla; Cameron, David A.; Olorunju, Steve; Luthuli, T; Dunbar, Rory; Naidoo, Pamela

doi:10.5588/pha.15.0003

Cited by 5 publications

(6 citation statements)

References 8 publications

(6 reference statements)

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“…A Western Cape study reported 17% of smear positive cases not being reported and started on treatment [8] while studies performed in Gauteng and Kwazulu-Natal reported around 20% of cases not being recorded in the TB register [9, 10]. Other studies found that the accuracy and completeness of data in the TB treatment register linked with the central laboratory data were inadequate and that a high number of bacteriologically confirmed cases were not included in the TB register [11, 12]. A recent study in 2015 reported on a national evaluation of the ETR.net for a period in 2009 and found that not all TB diagnosed patients were captured and the completeness and reliability of the electronic data was inconsistent across different data sources [13].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis cure rates and the ETR.Net: investigating the quality of reporting treatment outcomes from primary healthcare facilities in Mpumalanga province, South Africa

Dreyer

Mbambo²,

Machaba³

et al. 2017

BMC Health Serv Res

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BackgroundTuberculosis control programs rely on accurate collection of routine surveillance data to inform program decisions including resource allocation and specific interventions. The electronic TB register (ETR.Net) is dependent on accurate data transcription from both paperbased clinical records and registers at the facilities to report treatment outcome data. The study describes the quality of reporting of TB treatment outcomes from facilities in the Ehlanzeni District, Mpumalanga Province.MethodsA descriptive crossectional study of primary healthcare facilities in the district for the period 1 January – 31 December 2010 was performed.New smear positive TB cure rate data was obtained from the ETR.Net followed by verification of paperbased clinical records, both TB folders and the TB register, of 20% of all new smear positive cases across the district for correct reporting to the ETR.Net. Facilities were grouped according to high (>70%) and low cure rates (≤ 70%) as well as high (> 20%) and low (≤ 20%) error proportions in reporting. Kappa statistic was used to determine agreement between paperbased record, TB register and ETR.Net.ResultsOf the100 facilities (951 patient clinical records), 51(51%) had high cure rates and high error proportions, 14(14%) had a high cure rate and low error proportion whereas 30(30%) had low cure rates and high error proportions and five (5%) had a low cure rate with low error proportion. Fair agreement was observed (Kappa = 0.33) overall and between registers. Of the 473 patient clinical records which indicated cured, 383(81%) was correctly captured onto the ETR.Net, whereas 51(10.8%) was incorrectly captured and 39(8.2%) was not captured at all. Over reporting of treatment success of 12% occurred on the ETR.Net.ConclusionsThe high error proportion in reporting onto the ETR.Net could result in a false sense of improvement in the TB control programme in the Ehlanzeni district.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis cure rates and the ETR.Net: investigating the quality of reporting treatment outcomes from primary healthcare facilities in Mpumalanga province, South Africa

Dreyer

Mbambo²,

Machaba³

et al. 2017

BMC Health Serv Res

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“…In 2018, the bacteriological diagnostic rate for Africa was 65% (3) which is higher than that of Katsina state and half of the LGAs in the state in 2018 and 2019. Similar studies conducted in other lowand middle-income countries attribute low bacteriological diagnostic rates to improper documentation, improper referral, the inability of the presumptive case to produce sputum, overworked laboratory staff, stockouts of the commodities required to perform the test, and faulty equipment (32)(33)(34). The decrease in bacteriological diagnostic rate over the years in combination with identification of an increasing number of presumptive cases accessing care in the limited diagnostic facilities whose number remained relatively unchanged over the three years, suggests that ©PAGEPRESS PUBLICATIONS MILAHAM ET AL. the available diagnostic resources were insufficient for the increased demand.…”

Section: Discussionmentioning

confidence: 67%

Assessment of tuberculosis case notification rate: spatial mapping of hotspot, coverage and diagnostics in Katsina State, north-western Nigeria

Milaham

Gurp²,

Adewusi³

et al. 2022

J. Public Health Afr.

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Tuberculosis (TB) is prevalent in Nigeria, and Katsina, along with other 12 states in the country, accounts for a high proportion of unnotified TB cases: constituting the high priority-intervention States in the country. Interventions focused on TB detection and coverage in the state could benefit from a better understanding of hotspot Local Government Areas (LGAs) that trigger and sustain the disease. Therefore, this study investigated the spatial distribution of TB Case Notification Rates (CNRs), diagnostics and coverage across the LGAs. Using 2017 to 2019 TB case finding data, the geocoordinates of diagnostic facilities and shapefiles, a retrospective ecological study was conducted. The data were analysed with QGIS and GeoDa. Moran’s I and LISA were used to locate and quantify hotspots. The coverage of microscopy and GeneXpert facilities was assessed on QGIS using a 5 km and 20 km radius, respectively. The CNR in the state, and 29 of the 34 LGAs, increased steadily from 2017 to 2019. Hotspots of high CNRs were also identified in 2017 (Moran’s I=0.106, p-value=0.090) and 2018 (Moran’s I=-0.020, p-value=0.370). While CNRs increased along with presumptive TB rates across most LGAs over the years, the positivity yield and bacteriological and Xpert diagnostic rates decreased. Bacteriological and GeneXpert coverage were 78% and 49% respectively. Additionally, only 51% of the state’s population lived within 20km of a GeneXpert facility. These results suggest that TB program interventions had some positive impact on the CNR, however, diagnostic facilities need to be equitably distributed and more innovative approaches need to be explored to find the missing cases.

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“…Further, our study found that sputum smear test coverage and the percentage of sputum smear positive cases decreased in 2020 (n = 60 tests, 15.1% of the total number of cases in that year where 76.7% of cases were sputum smear positive) compared to 2010 (n = 189 tests, 49.2% of the total cases in that year where 92.1% of cases were sputum smear positive). Other studies have shown that sputum smear test coverage and positivity rate are universally low in children (average of 6.8% sputum smear positivity) compared to adults (average of 52.0% sputum smear positivity) (Mngomezulu et al 2015;Kunkel et al 2016).…”

Section: Discussionmentioning

confidence: 97%

Childhood Tuberculosis in Mongolia: Trends and Estimates, 2010-2030

Zanaa

Paramita

Erdenee

et al. 2022

Tohoku J. Exp. Med.

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Mongolia was listed among the 30 countries with a high tuberculosis burden in 2021.Approximately 10 -11% of the tuberculosis cases are of children, which is higher than the global average (6.0%). As children are a vulnerable population, it is important to understand the current situation and prioritize the development of tuberculosis prevention strategies. However, only few studies have addressed childhood tuberculosis in Mongolia. Therefore, we aimed to describe the characteristics of childhood tuberculosis and to show its trends and estimates in Mongolia. We performed descriptive and trend analyses on secondary data from the National Center for Communicable Diseases from 2010 to 2020. A total of 4,242 childhood tuberculosis cases, compiled from nine districts of the capital city and 21 provinces, were analyzed. We found that tuberculosis occurred more frequently in school-age children, and 71.8% of the all cases were an extrapulmonary tuberculosis. Trend analysis revealed that childhood tuberculosis continuously increased with fluctuations from 2018 onwards. The central region, including the capital city of Ulaanbaatar, is the most tuberculosis-burdened. Childhood tuberculosis is estimated to increase in the central region and decrease in the others from 2021 to 2030. Our findings showed that the national childhood tuberculosis trend is increasing, although there are differences in the pattern between regions. Further studies are needed to identify the determinant factors of regional differences, and age-specific public health interventions, such as scale-up screening and preventive treatment, are in demand in high-prevalence areas.

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Reasons for the low bacteriological coverage of tuberculosis reported in Mpumalanga Province, South Africa

Abstract: Both poor clinical practice (especially in hospitals) and poor record keeping have contributed to the low bacteriological coverage reported. These shortcomings need to be addressed to improve patient care and programme management.

Cited by 5 publications

References 8 publications

Tuberculosis cure rates and the ETR.Net: investigating the quality of reporting treatment outcomes from primary healthcare facilities in Mpumalanga province, South Africa

Tuberculosis cure rates and the ETR.Net: investigating the quality of reporting treatment outcomes from primary healthcare facilities in Mpumalanga province, South Africa

Assessment of tuberculosis case notification rate: spatial mapping of hotspot, coverage and diagnostics in Katsina State, north-western Nigeria

Childhood Tuberculosis in Mongolia: Trends and Estimates, 2010-2030

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