Are Tuberculosis Patients in a Tertiary Care Hospital in Hyderabad, India Being Managed According to National Guidelines?

Kondapaka, Kiran Kumar; Prasad, Surapaneni Venkateswara; Satyanarayana, Srinath; Kandi, Subhakar; Zachariah, Rony; Harries, Anthony; Nagaraja, Sharath Burugina; Tetali, Shailaja; Anchala, Raghupathy; Kannuri, Nanda Kishore; Murthy, Krishna R; Koppu, Dhanamurthy; Vangari, Latha; Rao, S. Jaya Prakash

doi:10.1371/journal.pone.0030281

Cited by 7 publications

(6 citation statements)

References 1 publication

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“…Two studies assessed practices among in-patients in tertiary care hospital settings and found very high rates of adherence to guidelines. 39,41 In contrast, one study assessed the correctness of both the combination of drugs and the dosages in the out-patient setting and found that in most cases neither the dosages nor the drug combinations were in line with ISTC recommendations. 42 …”

Section: Resultsmentioning

confidence: 99%

Quality of tuberculosis care in India: a systematic review

Satyanarayana¹,

Subbaraman²,

Shete³

et al. 2015

int j tuberc lung dis

119

123

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SUMMARY BACKGROUND While Indian studies have assessed care providers’ knowledge and practices, there is no systematic review on the quality of tuberculosis (TB) care. METHODS We searched multiple sources to identify studies (2000–2014) on providers’ knowledge and practices. We used the International Standards for TB Care to benchmark quality of care. RESULTS Of the 47 studies included, 35 were questionnaire surveys and 12 used chart abstraction. None assessed actual practice using standardised patients. Heterogeneity in the findings precluded meta-analysis. Of 22 studies evaluating provider knowledge about using sputum smears for diagnosis, 10 found that less than half of providers had correct knowledge; 3 of 4 studies assessing self-reported practices by providers found that less than a quarter reported ordering smears for patients with chest symptoms. In 11 of 14 studies that assessed treatment, less than one third of providers knew the standard regimen for drug-susceptible TB. Adherence to standards in practice was generally lower than correct knowledge of those standards. Eleven studies with both public and private providers found higher levels of appropriate knowledge/practice in the public sector. CONCLUSIONS Available evidence suggests suboptimal quality of TB care, particularly in the private sector. Improvement of quality of care should be a priority for India.

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Section: Resultsmentioning

confidence: 99%

Quality of tuberculosis care in India: a systematic review

Satyanarayana¹,

Subbaraman²,

Shete³

et al. 2015

int j tuberc lung dis

119

123

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“…Few studies have assessed the successful linkage for continuing anti-TB treatment after referral from medical colleges in India, where a large proportion of all TB patients are diagnosed and referred. [12] In the present study, only 13 (0.9%) patients were started on treatment at the DOTS center of the medical colleges and majority (87.6%) of the TB patients diagnosed were referred to start and continue treatment at the PHIs. Among those thirteen patients, who were started on treatment at the DOTS centre of medical colleges, seven patients were offered non-DOTS or non-RNTCP drug regimens.…”

Section: Discussionmentioning

confidence: 55%

Notified or missed cases? An assessment of successful linkage for referred tuberculosis patients in South India

Chauhan

Purty

Singh

2015

Community Acquir Infect

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India has one of the largest and well-run national TB control programs in the world. Although, India's TB control program is on track as far as reduction in disease burden is concerned, [2] it is essential to have complete information of all TB cases to ensure proper case management, reduce TB transmission and address the problems of emergence of spread of drug-resistant TB.The Government of India declared TB as a notifiable disease in 2012 but nearly one-third of the three million missed cases

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“…Among 138 MDR-TB patients hospitalized, only seven (5%) had unfavorable outcomes (death or a worsened clinical condition). This proportion is lower compared to a study that included drug-susceptible and drug-resistant TB patients admitted to a tertiary hospital in India (14%) [ 15 ].…”

Section: Discussionmentioning

confidence: 76%

Discharge Outcomes of Severely Sick Patients Hospitalized with Multidrug-Resistant Tuberculosis, Comorbidities, and Serious Adverse Events in Kyrgyz Republic, 2020–2022

Alumkulova,

Hazoyan,

Zhdanova

et al. 2023

TropicalMed

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Patients with multidrug-resistant tuberculosis (MDR-TB) who have comorbidities, complications, and experience serious adverse events (SAEs) are at substantial risk of having unfavorable hospital outcomes. We assessed characteristics and discharge outcomes of 138 MDR-TB patients hospitalized in the National Referral Center of Bishkek, Kyrgyz Republic, from January 2020 to August 2022. The main clinical characteristics included pulmonary complications (23%), malnutrition (33%), severe anemia (17%), diabetes mellitus (13%), viral hepatitis B and C (5%), and HIV infection (3%). Of those patients, 95% were successfully managed and discharged from hospital. Seven patients had unfavorable discharge outcomes (three patients died and four had a worsened clinical condition). Comorbidities (diabetes, and/or HIV), severe anemia, pulmonary complications, cardiovascular disorders, alcohol abuse, and SAEs were associated with unfavorable discharge outcomes. Sixty-five percent of the patients had SAEs, with electrolyte imbalance (25%), gastrointestinal disease (18%), hepatotoxicity (16%), and anemia (14%) being the most frequent. Successful resolution occurred in 91% of patients with SAEs. In summary, our study documented that sick patients who were hospitalized with MDR-TB were well managed and had good hospital discharge outcomes, despite the fact that they had comorbidities, complications, and SAEs. This information should assist in the referral and management of such patients in the future.

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Are Tuberculosis Patients in a Tertiary Care Hospital in Hyderabad, India Being Managed According to National Guidelines?

Cited by 7 publications

References 1 publication

Quality of tuberculosis care in India: a systematic review

Quality of tuberculosis care in India: a systematic review

Notified or missed cases? An assessment of successful linkage for referred tuberculosis patients in South India

Discharge Outcomes of Severely Sick Patients Hospitalized with Multidrug-Resistant Tuberculosis, Comorbidities, and Serious Adverse Events in Kyrgyz Republic, 2020–2022

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