Diagnostic accuracy of paper-based reporting of tuberculosis treatment outcomes in rural eastern Uganda

Abstract

Inaccurate reporting of tuberculosis (TB) data to the district and national TB control programmes undermines effective TB control, yet this remains understudied. This study assessed the accuracy of the paper-based approach compared with the World Health Organization (WHO) standard TB treatment outcome as the gold standard for the determination of TB treatment outcome. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the paper-based approach, as well as the percentage agreement between the paper-based approach and the WHO standard TB treatment outcome, are reported. Data from 987 participants were used. Ninety-three participants were misclassified as cured and 195 were misclassified as not cured by the paper-based approach, giving 62.7% sensitivity, 80.0% specificity, 77.9% PPV, 65.5% NPV and percentage agreement of 70.8%. Treatment failure had 64.7% sensitivity, 99.9% specificity, 52.4% PPV, 99.4% NPV, and percentage agreement of 98.4%. Treatment success had 98.8% sensitivity, 96.8% specificity, 99.2% PPV and 94.8% NPV. The paper-based approach was found to report treatment success accurately, but did not report cure and treatment failure accurately. Interventions are thus required to improve the accuracy of the paper-based approach.