TB burden and diagnostic challenges at Sandaun Provincial Hospital in West Sepik Province of PNG, 2016-2021.

IF 1.3 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2024-09-01 DOI:10.5588/pha.24.0016

S Bita, T Kelebi, A Holmes, S Vaccher, S S Majumdar, J Greig

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Abstract

Setting: Bacteriological confirmation of TB diagnosis remains a key operational challenge in Papua New Guinea. Sandaun Provincial Hospital (SPH) is the main TB diagnostic and treatment centre of West Sepik Province.

Objective: To evaluate TB caseload, patient characteristics, and quality of diagnosis at SPH between 2016 and 2021.

Design: A retrospective descriptive study using TB treatment, laboratory, and presumptive TB registers to collect data on all TB patients. We used multivariable logistic regression to determine factors associated with bacteriological confirmation.

Results: Of 1,305 TB patients registered, 25% were children (<15 years) and 30% had extrapulmonary TB. The quality of sputum was associated with a positive smear microscopy result (P = 0.002). The proportion bacteriologically confirmed was low (37.3%), being higher in young adults 15-44 years (50.6%, 377/745) than in children <15 years (6.3%, 20/319) or older adults ≥45 years (37.6%, 68/181). Bacteriological confirmation was less likely in people travelling ≥3 hours to a health facility (adjusted OR 0.58, 95% CI 0.34-0.97) and extrapulmonary TB (aOR 0.01, 95% CI 0.00-0.03) but more likely for retreatment cases (aOR 1.59, 95% CI 1.00-2.51).

Conclusion: Diagnostic services in West Sepik Province need strengthening to achieve a higher proportion of bacteriological confirmation in new pulmonary and extrapulmonary TB cases of all ages and improve access for the rural population.

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2016-2021 年巴布亚新几内亚西塞皮克省 Sandaun 省立医院的结核病负担和诊断挑战。

背景：在巴布亚新几内亚，结核病诊断的细菌学确认仍然是一项关键的业务挑战。桑达恩省医院（SPH）是西塞皮克省主要的结核病诊断和治疗中心：评估2016年至2021年期间SPH的结核病例数、患者特征和诊断质量：设计：一项回顾性描述性研究，使用结核病治疗、实验室和推定结核病登记册收集所有结核病患者的数据。我们使用多变量逻辑回归来确定与细菌学确诊相关的因素：在登记的 1305 名肺结核患者中，25% 是儿童（P = 0.002）。经细菌学确诊的比例较低（37.3%），15-44 岁青壮年的比例（50.6%，377/745）高于儿童：西塞皮克省需要加强诊断服务，以提高各年龄段肺部和肺外结核病新发病例的细菌学确诊比例，并改善农村人口的就医条件。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.