Challenges in TB diagnosis and treatment

the Kavieng Provincial Hospital experience, Papua New Guinea

K. Sodeng, A. Botu, M. Semmie, Mition Yoannes, H. D. Shewade, Robert Commons, Stephen Graham, P. du Cros

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Setting: The Tuberculosis (TB) Basic Management Unit at Kavieng Provincial Hospital, New Ireland Province, Papua New Guinea.

Objective: To assess the linkage between laboratory diagnosis and treatment initiation and describe the characteristics and treatment outcomes of TB patients.

Design: This was a retrospective cohort study of 1) sputum smear-positive TB patients recorded in the laboratory register, and 2) TB patients recorded in the treatment register in 2015 and 2016.

Results: Of the 221 patients registered for TB treatment, 173 (78%) were clinically diagnosed; extrapulmonary TB was common (36% of all patients). Unfavourable treatment outcomes were seen in more than 40% of patients, including death (10%) and loss to follow-up (26%), and were significantly more common in smear-negative vs. smear-positive pulmonary TB patients (RR 1.69 [95%CI 1.02–2.80]). Only 4 (<2%) TB patients had undergone testing for HIV. Twelve (21%) of 58 sputum smear-positive TB patients were not registered as undergoing treatment for TB.

Conclusion: This study identifies diagnostic and treatment gaps in the TB treatment cascade at the Kavieng Basic Management Unit. The TB programme requires strengthening to address the high proportions of clinically diagnosed TB, of patients not tested for HIV and of loss to follow-up
Original languageEnglish
Pages (from-to)S57-S61
Number of pages5
JournalPublic Health Action
Volume9
Issue numberSupplement 1
DOIs
Publication statusPublished - 21 Sep 2019

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Papua New Guinea
Tuberculosis
Therapeutics
Sputum
HIV
Clinical Laboratory Techniques
Ireland
Pulmonary Tuberculosis
Cohort Studies

Cite this

Sodeng, K., Botu, A., Semmie, M., Yoannes, M., Shewade, H. D., Commons, R., ... du Cros, P. (2019). Challenges in TB diagnosis and treatment: the Kavieng Provincial Hospital experience, Papua New Guinea. Public Health Action, 9(Supplement 1), S57-S61. https://doi.org/10.5588/pha.18.0066
Sodeng, K. ; Botu, A. ; Semmie, M. ; Yoannes, Mition ; Shewade, H. D. ; Commons, Robert ; Graham, Stephen ; du Cros, P. / Challenges in TB diagnosis and treatment : the Kavieng Provincial Hospital experience, Papua New Guinea. In: Public Health Action. 2019 ; Vol. 9, No. Supplement 1. pp. S57-S61.
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abstract = "Setting: The Tuberculosis (TB) Basic Management Unit at Kavieng Provincial Hospital, New Ireland Province, Papua New Guinea.Objective: To assess the linkage between laboratory diagnosis and treatment initiation and describe the characteristics and treatment outcomes of TB patients.Design: This was a retrospective cohort study of 1) sputum smear-positive TB patients recorded in the laboratory register, and 2) TB patients recorded in the treatment register in 2015 and 2016.Results: Of the 221 patients registered for TB treatment, 173 (78{\%}) were clinically diagnosed; extrapulmonary TB was common (36{\%} of all patients). Unfavourable treatment outcomes were seen in more than 40{\%} of patients, including death (10{\%}) and loss to follow-up (26{\%}), and were significantly more common in smear-negative vs. smear-positive pulmonary TB patients (RR 1.69 [95{\%}CI 1.02–2.80]). Only 4 (<2{\%}) TB patients had undergone testing for HIV. Twelve (21{\%}) of 58 sputum smear-positive TB patients were not registered as undergoing treatment for TB.Conclusion: This study identifies diagnostic and treatment gaps in the TB treatment cascade at the Kavieng Basic Management Unit. The TB programme requires strengthening to address the high proportions of clinically diagnosed TB, of patients not tested for HIV and of loss to follow-up",
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Sodeng, K, Botu, A, Semmie, M, Yoannes, M, Shewade, HD, Commons, R, Graham, S & du Cros, P 2019, 'Challenges in TB diagnosis and treatment: the Kavieng Provincial Hospital experience, Papua New Guinea', Public Health Action, vol. 9, no. Supplement 1, pp. S57-S61. https://doi.org/10.5588/pha.18.0066

Challenges in TB diagnosis and treatment : the Kavieng Provincial Hospital experience, Papua New Guinea. / Sodeng, K.; Botu, A.; Semmie, M.; Yoannes, Mition; Shewade, H. D.; Commons, Robert; Graham, Stephen; du Cros, P.

In: Public Health Action, Vol. 9, No. Supplement 1, 21.09.2019, p. S57-S61.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Challenges in TB diagnosis and treatment

T2 - the Kavieng Provincial Hospital experience, Papua New Guinea

AU - Sodeng, K.

AU - Botu, A.

AU - Semmie, M.

AU - Yoannes, Mition

AU - Shewade, H. D.

AU - Commons, Robert

AU - Graham, Stephen

AU - du Cros, P.

PY - 2019/9/21

Y1 - 2019/9/21

N2 - Setting: The Tuberculosis (TB) Basic Management Unit at Kavieng Provincial Hospital, New Ireland Province, Papua New Guinea.Objective: To assess the linkage between laboratory diagnosis and treatment initiation and describe the characteristics and treatment outcomes of TB patients.Design: This was a retrospective cohort study of 1) sputum smear-positive TB patients recorded in the laboratory register, and 2) TB patients recorded in the treatment register in 2015 and 2016.Results: Of the 221 patients registered for TB treatment, 173 (78%) were clinically diagnosed; extrapulmonary TB was common (36% of all patients). Unfavourable treatment outcomes were seen in more than 40% of patients, including death (10%) and loss to follow-up (26%), and were significantly more common in smear-negative vs. smear-positive pulmonary TB patients (RR 1.69 [95%CI 1.02–2.80]). Only 4 (<2%) TB patients had undergone testing for HIV. Twelve (21%) of 58 sputum smear-positive TB patients were not registered as undergoing treatment for TB.Conclusion: This study identifies diagnostic and treatment gaps in the TB treatment cascade at the Kavieng Basic Management Unit. The TB programme requires strengthening to address the high proportions of clinically diagnosed TB, of patients not tested for HIV and of loss to follow-up

AB - Setting: The Tuberculosis (TB) Basic Management Unit at Kavieng Provincial Hospital, New Ireland Province, Papua New Guinea.Objective: To assess the linkage between laboratory diagnosis and treatment initiation and describe the characteristics and treatment outcomes of TB patients.Design: This was a retrospective cohort study of 1) sputum smear-positive TB patients recorded in the laboratory register, and 2) TB patients recorded in the treatment register in 2015 and 2016.Results: Of the 221 patients registered for TB treatment, 173 (78%) were clinically diagnosed; extrapulmonary TB was common (36% of all patients). Unfavourable treatment outcomes were seen in more than 40% of patients, including death (10%) and loss to follow-up (26%), and were significantly more common in smear-negative vs. smear-positive pulmonary TB patients (RR 1.69 [95%CI 1.02–2.80]). Only 4 (<2%) TB patients had undergone testing for HIV. Twelve (21%) of 58 sputum smear-positive TB patients were not registered as undergoing treatment for TB.Conclusion: This study identifies diagnostic and treatment gaps in the TB treatment cascade at the Kavieng Basic Management Unit. The TB programme requires strengthening to address the high proportions of clinically diagnosed TB, of patients not tested for HIV and of loss to follow-up

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M3 - Article

VL - 9

SP - S57-S61

JO - Public Health Action

JF - Public Health Action

SN - 2220-8372

IS - Supplement 1

ER -

Sodeng K, Botu A, Semmie M, Yoannes M, Shewade HD, Commons R et al. Challenges in TB diagnosis and treatment: the Kavieng Provincial Hospital experience, Papua New Guinea. Public Health Action. 2019 Sep 21;9(Supplement 1):S57-S61. https://doi.org/10.5588/pha.18.0066