Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia

<p>Abstract</p> <p>Background</p> <p>Early and accurate diagnosis of pulmonary tuberculosis (TB) is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO) recommends the use of a diagnostic algo...

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Main Authors: Ahmad Riris, Matthys Francine, Dwihardiani Bintari, Rintiswati Ning, de Vlas Sake J, Mahendradhata Yodi, van der Stuyft Patrick
Format: Article
Language:English
Published: BMC 2012-02-01
Series:BMC Public Health
Subjects:
Online Access:http://www.biomedcentral.com/1471-2458/12/132
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author Ahmad Riris
Matthys Francine
Dwihardiani Bintari
Rintiswati Ning
de Vlas Sake J
Mahendradhata Yodi
van der Stuyft Patrick
author_facet Ahmad Riris
Matthys Francine
Dwihardiani Bintari
Rintiswati Ning
de Vlas Sake J
Mahendradhata Yodi
van der Stuyft Patrick
author_sort Ahmad Riris
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Early and accurate diagnosis of pulmonary tuberculosis (TB) is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO) recommends the use of a diagnostic algorithm. Our study evaluated the implementation of the national tuberculosis programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. The diagnostic algorithm is based on the WHO TB diagnostic algorithm, which had already been implemented in the health facilities.</p> <p>Methods</p> <p>We prospectively documented the diagnostic work-up of all new tuberculosis suspects until a diagnosis was reached. We used clinical audit forms to record each step chronologically. Data on the patient's gender, age, symptoms, examinations (types, dates, and results), and final diagnosis were collected.</p> <p>Results</p> <p>Information was recorded for 754 TB suspects; 43.5% of whom were lost during the diagnostic work-up in health centres, 0% in lung clinics. Among the TB suspects who completed diagnostic work-ups, 51.1% and 100.0% were diagnosed without following the national TB diagnostic algorithm in health centres and lung clinics, respectively. However, the work-up in the health centres and lung clinics generally conformed to international standards for tuberculosis care (ISTC). Diagnostic delays were significantly longer in health centres compared to lung clinics.</p> <p>Conclusions</p> <p>The high rate of patients lost in health centres needs to be addressed through the implementation of TB suspect tracing and better programme supervision. The national TB algorithm needs to be revised and differentiated according to the level of care.</p>
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spelling doaj.art-c6e1e70cac68434da5aeb6c845a9a0b02022-12-22T03:24:51ZengBMCBMC Public Health1471-24582012-02-0112113210.1186/1471-2458-12-132Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, IndonesiaAhmad RirisMatthys FrancineDwihardiani BintariRintiswati Ningde Vlas Sake JMahendradhata Yodivan der Stuyft Patrick<p>Abstract</p> <p>Background</p> <p>Early and accurate diagnosis of pulmonary tuberculosis (TB) is critical for successful TB control. To assist in the diagnosis of smear-negative pulmonary TB, the World Health Organisation (WHO) recommends the use of a diagnostic algorithm. Our study evaluated the implementation of the national tuberculosis programme's diagnostic algorithm in routine health care settings in Jogjakarta, Indonesia. The diagnostic algorithm is based on the WHO TB diagnostic algorithm, which had already been implemented in the health facilities.</p> <p>Methods</p> <p>We prospectively documented the diagnostic work-up of all new tuberculosis suspects until a diagnosis was reached. We used clinical audit forms to record each step chronologically. Data on the patient's gender, age, symptoms, examinations (types, dates, and results), and final diagnosis were collected.</p> <p>Results</p> <p>Information was recorded for 754 TB suspects; 43.5% of whom were lost during the diagnostic work-up in health centres, 0% in lung clinics. Among the TB suspects who completed diagnostic work-ups, 51.1% and 100.0% were diagnosed without following the national TB diagnostic algorithm in health centres and lung clinics, respectively. However, the work-up in the health centres and lung clinics generally conformed to international standards for tuberculosis care (ISTC). Diagnostic delays were significantly longer in health centres compared to lung clinics.</p> <p>Conclusions</p> <p>The high rate of patients lost in health centres needs to be addressed through the implementation of TB suspect tracing and better programme supervision. The national TB algorithm needs to be revised and differentiated according to the level of care.</p>http://www.biomedcentral.com/1471-2458/12/132Diagnostic work-upTuberculosisTB DOTS facilitiesIndonesia
spellingShingle Ahmad Riris
Matthys Francine
Dwihardiani Bintari
Rintiswati Ning
de Vlas Sake J
Mahendradhata Yodi
van der Stuyft Patrick
Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia
BMC Public Health
Diagnostic work-up
Tuberculosis
TB DOTS facilities
Indonesia
title Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia
title_full Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia
title_fullStr Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia
title_full_unstemmed Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia
title_short Diagnostic work-up and loss of tuberculosis suspects in Jogjakarta, Indonesia
title_sort diagnostic work up and loss of tuberculosis suspects in jogjakarta indonesia
topic Diagnostic work-up
Tuberculosis
TB DOTS facilities
Indonesia
url http://www.biomedcentral.com/1471-2458/12/132
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