Pre-diagnosis attrition needs to be addressed urgently if we are to make progress in improving MDR-TB case detection and achieve universal access to MDR-TB care. The authors report the pre-diagnosis attrition, along with factors associated, and turnaround times related to the diagnostic pathway among patient with presumptive MDR-TB in Bhopal district, central India (2014).
Study was conducted under the Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all registered TB cases in Bhopal district that met the presumptive MDR-TB criteria (eligible for DST) in 2014.
High pre-diagnosis attrition was contributed by failure to identify and refer patients. Attrition reduced modestly with time and one factor that might have contributed to this was introduction of CbNAAT in quarter 2 of 2014. General health system strengthening which includes improvement in identification/referral and patient tracking with focus on those with higher risk for not undergoing DST is urgently required.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Shewade HD, Kokane AM, Singh AR, Verma M, Parmar M, Chauhan A, Chahar SS, Tiwari M, Khan SN, Gupta V, Tripathy JP, Nagar M, Singh SK, Mehra PK, Kumar AM V. High pre-diagnosis attrition among patients with presumptive MDR-TB: an operational research from Bhopal district, India. BMC Health Services Research. 2017;17(1):249.
High pre-diagnosis attrition among patients with presumptive MDR-TB: an operational research from Bhopal district, India