Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays

Detalhes bibliográficos
Autor(a) principal: Lisboa, Miguelhete
Data de Publicação: 2020
Outros Autores: Fronteira, I, Mason, Paul H., Martins, MR
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/116596
Resumo: Funding Information: This study was elaborated based on the work of Miguelhete Lisboa doctoral program, a Fundação Calouste Gulbenkian scholarship holder, and used grants obtained from The Special Programme for Research and Training in Tropical Diseases (TDR) and co-sponsored by the United Nations Children’s Fund (UNICEF), United Nations Development Programme (UNDP), World Bank, and World Health Organization (WHO)—award ID number: B40151/ 2014. The FCG and WHO/TDR were not involved in the design of the study and collection; analysis and interpretation of data; and writing the manuscript; therefore, the authors are responsible for all information. Publisher Copyright: © 2020 The Author(s).
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spelling Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delaysa quasi-experimental studyTuberculosisHospital auxiliary workers24-h TB laboratory using XpertSame-day TB diagnosis and treatmentHospital TB mortalityInfectious DiseasesHealth PolicySDG 3 - Good Health and Well-beingFunding Information: This study was elaborated based on the work of Miguelhete Lisboa doctoral program, a Fundação Calouste Gulbenkian scholarship holder, and used grants obtained from The Special Programme for Research and Training in Tropical Diseases (TDR) and co-sponsored by the United Nations Children’s Fund (UNICEF), United Nations Development Programme (UNDP), World Bank, and World Health Organization (WHO)—award ID number: B40151/ 2014. The FCG and WHO/TDR were not involved in the design of the study and collection; analysis and interpretation of data; and writing the manuscript; therefore, the authors are responsible for all information. Publisher Copyright: © 2020 The Author(s).Background In-hospital logistic management barriers (LMB) are considered to be important risk factors for delays in TB diagnosis and treatment initiation (TB-dt), which perpetuates TB transmission and the development of TB morbidity and mortality. We assessed the contribution of hospital auxiliary workers (HAWs) and 24-h TB laboratory services using Xpert (24h-Xpert) on the delays in TB-dt and TB mortality at Beira Central Hospital, Mozambique. Methods A quasi-experimental design was used. Implementation strategy—HAWs and laboratory technicians were selected and trained, accordingly. Interventions—having trained HAW and TB laboratory technicians as expediters of TB LMB issues and assurer of 24h-Xpert, respectively. Implementation outcomes—time from hospital admission to sputum examination results, time from hospital admission to treatment initiation, proportion of same-day TB cases diagnosed, initiated TB treatment, and TB patient with unfavorable outcome after hospitalization (hospital TB mortality). A nonparametric test was used to test the differences between groups and adjusted OR (95% CI) were computed using multivariate logistic regression. Results We recruited 522 TB patients. Median (IQR) age was 34 (16) years, and 52% were from intervention site, 58% males, 60% new case of TB, 12% MDR-TB, 72% TB/HIV co-infected, and 43% on HIV treatment at admission. In the intervention hospital, 93% of patients had same-day TB-dt in comparison with a median (IQR) time of 15 (2) days in the control hospital. TB mortality in the intervention hospital was lower than that in the control hospital (13% vs 49%). TB patients admitted to the intervention hospital were nine times more likely to obtain an early laboratory diagnosis of TB, six times more likely to reduce delays in TB treatment initiation, and eight times less likely to die, when compared to those who were admitted to the control hospital, adjusting for other factors. Conclusion In-hospital delays in TB-dt and high TB mortality in Mozambique are common and probably due, in part, to LMB amenable to poor-quality TB care. Task shifting of TB logistic management services to HAWs and lower laboratory technicians, to ensure 24h-Xpert through “on-the-spot strategy,” may contribute to timely TB detection, proper treatment, and reduction of TB mortality.Global Health and Tropical Medicine (GHTM)Instituto de Higiene e Medicina Tropical (IHMT)Population health, policies and services (PPS)RUNLisboa, MiguelheteFronteira, IMason, Paul H.Martins, MR2021-05-01T22:48:09Z2020-04-032020-04-03T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article11application/pdfhttp://hdl.handle.net/10362/116596eng1478-4491PURE: 17645134https://doi.org/10.1186/s12960-020-0457-2info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:59:14Zoai:run.unl.pt:10362/116596Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:43:09.081889Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
a quasi-experimental study
title Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
spellingShingle Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
Lisboa, Miguelhete
Tuberculosis
Hospital auxiliary workers
24-h TB laboratory using Xpert
Same-day TB diagnosis and treatment
Hospital TB mortality
Infectious Diseases
Health Policy
SDG 3 - Good Health and Well-being
title_short Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
title_full Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
title_fullStr Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
title_full_unstemmed Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
title_sort Using hospital auxiliary worker and 24-h TB services as potential tools to overcome in-hospital TB delays
author Lisboa, Miguelhete
author_facet Lisboa, Miguelhete
Fronteira, I
Mason, Paul H.
Martins, MR
author_role author
author2 Fronteira, I
Mason, Paul H.
Martins, MR
author2_role author
author
author
dc.contributor.none.fl_str_mv Global Health and Tropical Medicine (GHTM)
Instituto de Higiene e Medicina Tropical (IHMT)
Population health, policies and services (PPS)
RUN
dc.contributor.author.fl_str_mv Lisboa, Miguelhete
Fronteira, I
Mason, Paul H.
Martins, MR
dc.subject.por.fl_str_mv Tuberculosis
Hospital auxiliary workers
24-h TB laboratory using Xpert
Same-day TB diagnosis and treatment
Hospital TB mortality
Infectious Diseases
Health Policy
SDG 3 - Good Health and Well-being
topic Tuberculosis
Hospital auxiliary workers
24-h TB laboratory using Xpert
Same-day TB diagnosis and treatment
Hospital TB mortality
Infectious Diseases
Health Policy
SDG 3 - Good Health and Well-being
description Funding Information: This study was elaborated based on the work of Miguelhete Lisboa doctoral program, a Fundação Calouste Gulbenkian scholarship holder, and used grants obtained from The Special Programme for Research and Training in Tropical Diseases (TDR) and co-sponsored by the United Nations Children’s Fund (UNICEF), United Nations Development Programme (UNDP), World Bank, and World Health Organization (WHO)—award ID number: B40151/ 2014. The FCG and WHO/TDR were not involved in the design of the study and collection; analysis and interpretation of data; and writing the manuscript; therefore, the authors are responsible for all information. Publisher Copyright: © 2020 The Author(s).
publishDate 2020
dc.date.none.fl_str_mv 2020-04-03
2020-04-03T00:00:00Z
2021-05-01T22:48:09Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/116596
url http://hdl.handle.net/10362/116596
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1478-4491
PURE: 17645134
https://doi.org/10.1186/s12960-020-0457-2
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11
application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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