ArticleJournal of clinical tuberculosis and other mycobacterial diseases2019
Quality of care for patients evaluated for tuberculosis in the context of Xpert MTB/RIF scale-up.
Article in Journal of clinical tuberculosis and other mycobacterial diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Diagnostic Yield of Tongue Swab- Compared to Sputum-Based Molecular Testing for Tuberculosis in Four High-Burden Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Operationalization of rapid molecular test coverage for tuberculosis in different international contexts: a scoping review.Revista da Escola de Enfermagem da U S P · 2026Article
- Trends of notification rates and treatment outcomes of tuberculosis cases with and without HIV co-infection in eight rural districts of Uganda (2015 - 2019).BMC public health · 2022Article
- Is aggregated surveillance data a reliable method for constructing tuberculosis care cascades? A secondary data analysis from Uganda.PLOS global public health · 2022Article
- Patient Perspectives and Willingness to Accept Incentives for Tuberculosis Diagnostic Evaluation in Uganda.Value in health regional issues · 2021Article
- Study protocol: a cluster randomized trial to evaluate the effectiveness and implementation of onsite GeneXpert testing at community health centers in Uganda (XPEL-TB).Implementation science : IS · 2020Article
- Challenges with scale-up of GeneXpert MTB/RIF® in Uganda: a health systems perspective.BMC health services research · 2020Article
- Implementation science to improve the quality of tuberculosis diagnostic services in Uganda.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
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Authors and funding
16 authors.
Funding
Abstract
rationaleMany high-burden countries are scaling-up Xpert MTB/RIF using a hub-and-spoke model. We evaluated the quality of care for patients undergoing TB evaluation at microscopy centers (spokes) linked to Xpert testing sites (hubs) in Uganda.
objectivesTo characterize the extent to which patients were receiving care in accordance with international and national guidelines.
methodsWe conducted a prospective cohort study of all adults with presumptive pulmonary TB at 24 health centers linked to Xpert testing sites. Health center staff photographed TB registers, and uploaded photos to a secure server bi-weekly. We assessed the proportion of patients (1) initiating testing; (2) completing testing; and (3) treated for confirmed TB within 14 days. MEASUREMENTS AND MAIN
resultsBetween January to December 2017, 6744 patients underwent evaluation for pulmonary TB. Only 1316 patients had sputum referred for Xpert testing, including 1075/3229 (33.3%) people living with HIV and 241/3515 (6.9%) without HIV. Of 119 patients confirmed to have TB by Xpert testing, 44 (36%) did not initiate treatment. There were significant losses along the entire diagnostic cascade of care, with only 5330/6744 (79.0%) patients having samples referred for sputum-based testing, 2978/5330 (55.9%) patients completing recommended testing if referred, and 313/418 (74.9%) patients initiating treatment within 14 days if confirmed to have TB.
conclusionsAlthough coverage of Xpert testing services across Uganda is high, the quality of care delivered to patients undergoing TB evaluation remains poor. Further research is needed to identify health system interventions to facilitate uptake of Xpert testing and high-quality care.
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