ArticlePublic health action2023
Evaluating TB diagnosis and care in the Union of the Comoros.
Article in Public health action, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
settingThe Union of the Comoros has experienced a persistent notification gap in TB cases despite several strategic changes, including molecular diagnosis and contact investigation. We therefore performed a TB patient pathway analysis (PPA) under the National Tuberculosis Programme (NTP).
objectiveTo assess the alignment of healthcare-seeking behaviour and TB service availability to clarify the reasons for these missing cases.
designThree primary data sources, including a national list of health facilities, TB surveillance data and care-seeking behaviour data, were analysed at the national and regional levels to determine access to TB diagnosis and the initial point of care-seeking. Summary data were visualised using the standardised PPA Wizard programme, and the analysis was completed using demographic and socio-economic data.
resultsAt the initial point of care-seeking, 18% of patients had access to TB services, available only in nine centralised public health facilities. Furthermore, 30% of patients initially consulted in the informal sector and 45% in the formal public or private sector in health facilities, both of which lacked the capacity for TB diagnosis or first-line treatment.
conclusionThe concentration of and limited access to TB services at the intermediate and central levels of care indicate a need for decentralisation efforts.
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