ArticleBMJ open2022
Assessing the quality of tuberculosis care using routine surveillance data: a process evaluation employing the Zero TB Indicator Framework in Mongolia.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Bridging the Gap Between Treatment and Accountability: DR-TB Outcomes and Governance Signals in Rural Eastern Cape, South Africa (2020-2024).Infectious disease reports · 2026Article
- Vitamin D Status, Fasting Blood Glucose, and Latent Tuberculosis Infection in a High-Risk Population in Ulaanbaatar, Mongolia.Nutrients · 2025Article
- Prevalence of Tuberculosis in Central Asia and Southern Caucasus: A Systematic Literature Review.Diagnostics (Basel, Switzerland) · 2025Review
- Article
- Trends and disparities in tuberculosis burden in Kazakhstan and Mongolia (2017-2021): a comparative analysis using GBD metrics.Frontiers in public health · 2025Article
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Authors and funding
13 authors.
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Abstract
objectivesTo evaluate the feasibility of the Zero TB Indicator Framework as a tool for assessing the quality of tuberculosis (TB) case-finding, treatment and prevention services in Mongolia.
settingPrimary health centres, TB dispensaries, and surrounding communities in four districts of Mongolia.
designThree retrospective cross-sectional cohort studies, and two longitudinal studies each individually nested in one of the cohort studies.
participants15 947 community members from high TB-risk populations; 8518 patients screened for TB in primary health centres and referred to dispensaries; 857 patients with index TB and 2352 household contacts. PRIMARY AND SECONDARY OUTCOME MEASURES: 14 indicators of the quality of TB care defined by the Zero TB Indicator Framework and organised into three care cascades, evaluating community-based active case-finding, passive case-finding in health facilities and TB screening and prevention among close contacts; individual and health-system predictors of these indicators.
resultsThe cumulative proportions of participants receiving guideline-adherent care varied widely, from 96% for community-based active case-finding, to 79% for TB preventive therapy among household contacts, to only 67% for passive case-finding in primary health centres and TB dispensaries (range: 29%-80% across districts). The odds of patients completing active TB treatment decreased substantially with increasing age (aOR: 0.76 per decade, 95% CI: 0.71 to 0.83, p<0.001) and among men (aOR: 0.56, 95% CI: 0.36 to 0.88, p=0.013). Contacts of older index patients also had lower odds of initiating and completing of TB preventive therapy (aOR: 0.60 per decade, 95% CI: 0.38 to 0.93, p=0.022).
conclusionsThe Zero TB Framework provided a feasible and adaptable approach for using routine surveillance data to evaluate the quality of TB care and identify associated individual and health system factors. Future research should evaluate strategies for collecting process indicators more efficiently; gather qualitative data on explanations for low-quality care; and deploy quality improvement interventions.
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