To improve childhood Tuberculosis management, the National Tuberculosis Program implemented a package of interventions Hospital DOTS linkages (HDL) in 2015 in 144 tertiary and secondary care hospitals across Pakistan....To improve childhood Tuberculosis management, the National Tuberculosis Program implemented a package of interventions Hospital DOTS linkages (HDL) in 2015 in 144 tertiary and secondary care hospitals across Pakistan. This included systematic engagement of hospital administration and all specialist doctors, staff training and regular facility-based review meetings. HDL was associated with 35% increase in childhood TB notifications in 2015 (versus 2014) in HDL sites as compared to 16% increase in non-HDL sites. The increase was seen across provinces, age-groups and sexes, but did not correlate with presence of Xpert MTB/RIF®?or “screeners” (health workers deployed to screen children for TB).展开更多
To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals...To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals of Sindh, Pakistan in 2013. There was a 55% increase in childhood TB notifications in 2014 compared to 2012 in facilities with screeners (n = 8) compared to 40% increase in facilities without screeners (n = 22). This apparent association disappeared when stratified by presence of “trained pediatrician” whose introduction was associated with a massive increase in notifications while transfer was associated with a marked decrease. In conclusion, screeners were not associated with increase in pediatric TB case notifications.展开更多
The problem of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) co-infection becomes vital when it is seen in the context of under developed countries like Pakistan. Pakistan ranks 5th high burden countries f...The problem of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) co-infection becomes vital when it is seen in the context of under developed countries like Pakistan. Pakistan ranks 5th high burden countries for drug-susceptible and 6th among drug-resistant TB patients [1]. Objectives of the study were to assess the prevalence of TB-HIV Co-infection at the designated Sentinel Sites across Pakistan. A cross-sectional study is based on retrospective record review of routinely maintained TB program data at all 17 designated sentinel sites of TB Control Program from 2013-15. Among the screened TB patients 145 (0.66%) were found HIV reactive. The prevalence of HIV was higher (1.02%) in extra-pulmonary and male TB patients (1.23 %) as compared to pulmonary (0.55%) and female patients (0.09%). Scale up TB surveillance activities, integrating TB-HIV care services, active case finding among key affected populations will have a positive impact on TB-HIV co-infection and disease control.展开更多
文摘To improve childhood Tuberculosis management, the National Tuberculosis Program implemented a package of interventions Hospital DOTS linkages (HDL) in 2015 in 144 tertiary and secondary care hospitals across Pakistan. This included systematic engagement of hospital administration and all specialist doctors, staff training and regular facility-based review meetings. HDL was associated with 35% increase in childhood TB notifications in 2015 (versus 2014) in HDL sites as compared to 16% increase in non-HDL sites. The increase was seen across provinces, age-groups and sexes, but did not correlate with presence of Xpert MTB/RIF®?or “screeners” (health workers deployed to screen children for TB).
文摘To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals of Sindh, Pakistan in 2013. There was a 55% increase in childhood TB notifications in 2014 compared to 2012 in facilities with screeners (n = 8) compared to 40% increase in facilities without screeners (n = 22). This apparent association disappeared when stratified by presence of “trained pediatrician” whose introduction was associated with a massive increase in notifications while transfer was associated with a marked decrease. In conclusion, screeners were not associated with increase in pediatric TB case notifications.
文摘The problem of Tuberculosis (TB) and Human Immune Deficiency Virus (HIV) co-infection becomes vital when it is seen in the context of under developed countries like Pakistan. Pakistan ranks 5th high burden countries for drug-susceptible and 6th among drug-resistant TB patients [1]. Objectives of the study were to assess the prevalence of TB-HIV Co-infection at the designated Sentinel Sites across Pakistan. A cross-sectional study is based on retrospective record review of routinely maintained TB program data at all 17 designated sentinel sites of TB Control Program from 2013-15. Among the screened TB patients 145 (0.66%) were found HIV reactive. The prevalence of HIV was higher (1.02%) in extra-pulmonary and male TB patients (1.23 %) as compared to pulmonary (0.55%) and female patients (0.09%). Scale up TB surveillance activities, integrating TB-HIV care services, active case finding among key affected populations will have a positive impact on TB-HIV co-infection and disease control.
