Evidence map›Paper›PMID 39313290›Full record

ArticleBMJ open2024

Accessibility of TB diagnostic services at primary healthcare clinics in the eThekwini district, South Africa: a geospatial analysis.

Thobeka Dlangalala, Alfred Musekiwa, David Mckelly, Ethel Baloyi, Tivani Phosa Mashamba-Thompson

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Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Thobeka DlangalalaSchool of Health Systems and Public Health, Faculty of Health Sciences University of Pretoria Private Bag, Pretoria, South Africa u10225120@tuks.co.za.ORCID 0000-0003-1331-4247
Alfred MusekiwaSchool of Health Systems and Public Health, Faculty of Health Sciences University of Pretoria Private Bag, Pretoria, South Africa.ORCID 0000-0001-5880-3680
David MckellyCSIR, Cape Town, Inclusive Smart Settlements and Regions (ISSR) Central, South Africa.
Ethel BaloyiEkurhuleni Metropolitan Municipality, Germiston, Gauteng, South Africa.
Tivani Phosa Mashamba-ThompsonSchool of Health Systems and Public Health, Faculty of Health Sciences University of Pretoria Private Bag, Pretoria, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImproving geographic access can aid in managing tuberculosis (TB) by enabling early diagnosis and treatment initiation. Although geospatial techniques have been used to map the transmission patterns of drug-resistant TB in South Africa, fewer studies have investigated the accessibility of TB diagnostic services. This study evaluated the accessibility of TB diagnostic services and disease distribution in the eThekwini district of South Africa.

methodsIn this cross-sectional study, population data for 2021 were disaggregated into smaller analysis units and then re-aggregated through the dasymetric mapping technique. Data on notified TB patients, including Global Positioning System coordinates of clinics, were obtained from the District of Health Information System, exported to ArcGIS 10.8.2 and used to calculate distances to the nearest clinics and hospitals.

results92% of the population (3 730 494 people) in eThekwini could access TB diagnostic services within 5 km. Patients travelled an average distance of 4.7 km (range: 0.1-26.9 km). TB diagnostic services were highly accessible in the Northern and Central regions and moderately accessible in the predominately rural Western and Southern regions. The smallest population of eThekwini resides in rural areas; however, 40.7% of its residents live >5 km from a diagnosing facility, with patients in the South having to travel up to 44.5 km. TB incidence was higher in the predominately rural West and South regions compared with the Central and North regions which are mainly comprised of urban and suburban areas. Our findings also showed that 98.4% of the clinics in eThekwini were located within 30 km of a hospital at an average distance of 9.6 km within the district. However, the distribution of these hospitals does not demonstrate equitable access as the majority are located within the Central region, and fewer are found in the other three regions of eThekwini.

conclusionsAddressing the disparities in access to TB diagnostic services is required in the eThekwini district. Leveraging the existing mobile health clinics can assist with this, particularly, in rural areas with inadequate access. Additionally, active-case finding should be intensified in these regions since they had a higher TB burden per population. Prioritising interventions in these areas is crucial for reducing the impact of the disease on affected communities.

Indexed as

Health Services AccessibilityPrimary Health CareTuberculosisAdolescentAdultAmbulatory Care FacilitiesChildChild, PreschoolCross-Sectional StudiesDiagnostic ServicesFemaleGeographic Information SystemsHumansInfantMaleMiddle Agedhealth services accessibilityprimary health carepublic healthtuberculosis

Identifiers

PMID39313290
PMCPMC11418524

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.