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Int J Tuberc Lung Dis. 2010 Jul;14(7):872-7.

Diagnosis and outcome of childhood tuberculosis: implementing public health policy in three districts of Pakistan.

Author information

  • 1Association for Social Development, Islamabad, Pakistan; Centre for International Health, University of Bergen, Bergen, Norway. Nauman.Safdar@student.uib.no

Abstract

SETTING:

All nine public sector hospitals in three districts of Pakistan.

OBJECTIVE:

To estimate case notifications of children with tuberculosis (TB) and their outcomes.

DESIGN:

A retrospective cohort following all children aged <15 years placed on TB treatment under the National TB Control Programme (NTP) in public hospitals. The study period was 2 years before and 2 years after the implementation of new NTP policy guidelines for childhood TB. Data were collected from hospital TB registers, patient treatment cards and quarterly reports.

RESULTS:

With the introduction of the new NTP policy, case notification of childhood TB increased from 189 (2004-2005) to 731 for the 2 years 2006-2007. The annual notification rate of childhood TB cases increased from 1.4 (2004-2005) to 5.2 per 100 000 population (2006-2007). Of the total 920 childhood TB cases registered, 610 were pulmonary, 202 extra-pulmonary and the remaining 108 unclassified. The three-fold increase in case notification was accompanied by a lack of follow-up, resulting in an increase in unknown treatment outcomes from 21.7% to 73.3%.

CONCLUSION:

Managing children with TB in routine NTP practice is possible, but without adequate operational guidelines, expanding services and follow-up, it can lead to suboptimal results.

PMID:
20550771
[PubMed - indexed for MEDLINE]
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