TITLE

Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china

AUTHOR(S)
Xiaolin Wei; Guanyang Zou; Hui Zhang; Renzhong Li; Walley, John D.; Shiwen Jiang; Jia Yin; Shuigao Jin; You Li; Qiang Sun; Newell, James N.; Sian Griffiths; Lixia Wang
PUB. DATE
January 2011
SOURCE
BMC Public Health;2011, Vol. 11 Issue 1, p103
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. Methods: Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. Results: Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. Conclusion: Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study.
ACCESSION #
59753903

 

Related Articles

  • Hyperendemic pulmonary tuberculosis in peri-urban areas of Karachi, Pakistan. Akhtar, Saeed; White, Franklin; Hasan, Rumina; Rozi, Shafquat; Younus, Mohammad; Ahmed, Faiza; Husain, Sara; Khan, Bilquis Sana // BMC Public Health;2007, Vol. 7, p70 

    Background: Currently there are very limited empirical data available on the prevalence of pulmonary tuberculosis among residents of marginalized settings in Pakistan. This study assessed the prevalence of pulmonary tuberculosis through active case detection and evaluated predictors of pulmonary...

  • PREVALENCE OF PULMONARY TUBERCULOSIS IN FAR WESTERN NEPAL. Joshi, Y. P.; Mishra, P. N.; Joshi, D. D. // Journal of the Nepal Medical Association;Apr-Jun2005, Vol. 44 Issue 158, p47 

    Keeping in view of high prevalence of tuberculosis in far western development region in different reports, a door to door survey of 125 household was carried out randomly in Mahendra Nagar municipality ward no 13 of Kanchanpur district to pick up symptomatics suggestive of pulmonary tuberculosis...

  • Sputum microscopy for the diagnosis of HIV-associated pulmonary tuberculosis in Tanzania. Matee, Mecky; Mtei, Lillian; Lounasvaara, Tarja; Wieland-Alter, Wendy; Waddell, Richard; Lyimo, Johnson; Bakari, Muhammad; Pallangyo, Kisali; von Reyn, C. Fordham // BMC Public Health;2008, Vol. 8, p68 

    Background: In many resource poor settings only sputum microscopy is employed for the diagnosis of HIV-associated pulmonary tuberculosis; sputum culture may not be available. Methods: We determined the diagnostic accuracy of sputum microscopy for active case finding of HIV-associated pulmonary...

  • An Appraisal of PCR-Based Technology in the Detection of Mycobacterium tuberculosis. Sankar, Sathish; Ramamurthy, Mageshbabu; Nandagopal, Balaji; Sridharan, Gopalan // Molecular Diagnosis & Therapy;Jan2011, Vol. 15 Issue 1, p1 

    Tuberculosis is an under-recognized yet catastrophic health problem, particularly in developing countries. The HIV pandemic has served to increase the number of susceptible individuals, and multidrug-resistance and poor socioeconomic conditions also augment the prevalence and the consequences of...

  • A study on rapid confirmation of pulmonary tuberculosis in smear-negative acid fast bacilli cases by using fiberoptic bronchoscopy, done through a trans oro pharyngeal spacer. Chandra, T. Jaya; Dash, Somnath; Srinivas, G.; Rao, P. V. Prabhakara // Journal of Family & Community Medicine;2012, Vol. 19 Issue 1, p43 

    Introduction: The tuberculosis control program is based on a felt need--oriented basis. The diagnosis is mainly microbiological. However, sputum smear-negative Acid Fast Bacilli (AFB) cases with suspected radiological findings can be problematic in diagnosis. Objectives: To confirm the diagnosis...

  • Intensive Case Finding and Isoniazid Preventative Therapy in HIV Infected Individuals in Africa: Economic Model and Value of Information Analysis. Maheswaran, Hendramoorthy; Barton, Pelham // PLoS ONE;Jan2012, Vol. 7 Issue 1, p1 

    Background: Tuberculosis (TB) accounts of much of the morbidity and mortality associated with HIV. We evaluate the costeffectiveness of different strategies to actively screen for TB disease in HIV positive individuals, where isoniazid preventative therapy (IPT) is given to those screening...

  • ÇeÅŸitli Klinik Örneklerin EZN Boyama ve Tüberküloz Kültür Sonuçlarının DeÄŸerlendirilmesi. Yaman, Görkem; Parlak, Mehmet; Demirol, Meryem; Güdücüoğlu, Hüseyin; Berktaş, Mustafa // Ortadogu Medical Journal / Ortadogu Tip Dergisi;2012, Vol. 4 Issue 1, p19 

    Objective: In this study, stained preparation and tuberculosis (tbc) culture results from specimens that were sent from various clinics from January 2008 to December 2010 were evaluated retrospectively. Material and Methods: A total of 572 samples were evaluated with Ehrlich-Ziehl-Neelsen...

  • Medical charity criticises shortcomings of DOTS in management of tuberculosis. Mudur, Ganapati // BMJ: British Medical Journal (International Edition);4/3/2004, Vol. 328 Issue 7443, p784 

    Looks the shortcomings of direct observed treatments short course (DOTS) program in the management of tuberculosis. Outdated diagnostic tools and shortcomings in the DOTS program; Case detection for DOTS, which relies on sputum smear microscopy, a 19th century tool; Current detection rate of...

  • Evaluation of a New Commercial Assay for Diagnosis of Pulmonary and Nonpulmonary Tuberculosis. Johansen, I. S.; Thomsen, V. Ø; Johansen, A.; Andersen, P.; Lundgren, B. // European Journal of Clinical Microbiology & Infectious Diseases;Jun2002, Vol. 21 Issue 6, p455 

    A new commercial assay for the diagnosis of tuberculosis, the BDProbeTec ET Direct Detection assay (Becton Dickinson, USA), was evaluated using 351 respiratory and 372 nonrespiratory specimens. The results were compared to detection of Mycobacterium tuberculosis complex (MTC) by conventional...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics