Abstract
Background: Pakistan ranks among high tuberculosis (TB) burden countries, with about 200,000 missing TB cases. Despite significant increase in case detection and treatment outcomes through public-private mix (PPM) globally, the contribution of the private sector may vary in different parts of Pakistan Methods: This was a cross sectional study conducted in state of Azad Jammu and Kashmir (AJK), Pakistan. The study was a retrospective record review of routine TB notification and treatment outcomes for 2015 to 2016 in districts with and without a PPM approach. The study was conducted in all districts of AJK, including all public and private health facilities. Intra-district comparison in PPM supported districts was also carried out. Results: Total notified TB cases during 2015-16 were 11479. Districts with PPM support has notified 5882 (51.24%) of TB cases while districts without PPM support contributed 5597 (48.87%). Pulmonary clinical diagnosis was higher in PPM supported districts (45.43%) as compared to districts without PPM support (31.11%). Notification of extra pulmonary TB cases was lower in PPM supported districts (1256; 21.35%) as compared to districts without PPM support (1877; 33.54%). Unfavourable treatment outcomes (treatment failure, died, lost to follow-up) was higher in PPM facilities (5.84%). Conclusion: The study shows minimal increase in TB case finding through the PPM approach. While this is an important aspect in END TB strategy, this needs more careful evaluation.
Highlights
Tuberculosis (TB) remains a major public health problem, as it is the leading cause of death from a single infectious agent
The role of the public sector in management of TB was assessed in Thailand and it was concluded that 90% of TB cases were diagnosed and treated in public health facilities, while the private sector contributed only 10% in case notification and treatment[4]
Our study showed that TB case notification through publicprivate mix (PPM) was only 15% in PPM supported districts, but there was no such significant difference when PPM supported districts were compared with non-PPM districts
Summary
Tuberculosis (TB) remains a major public health problem, as it is the leading cause of death from a single infectious agent. A study from India showed that the public sector has contributed 84% in TB case notification[3]. The role of the public sector in management of TB was assessed in Thailand and it was concluded that 90% of TB cases were diagnosed and treated in public health facilities, while the private sector contributed only 10% in case notification and treatment[4]. Despite significant increase in case detection and treatment outcomes through publicprivate mix (PPM) globally, the contribution of the private sector may vary in different parts of Pakistan Methods: This was a cross sectional study conducted in state of Azad Jammu and Kashmir (AJK), Pakistan. Conclusion: The study shows minimal increase in TB case finding through the PPM approach. While this is an important aspect in END TB strategy, this needs more careful evaluation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
