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Are we missing 'previously treated' smear-positive pulmonary tuberculosis under programme settings in India? A
Hemant Deepak Shewade1,2, Vivek Gupta3, Srinath Satyanarayana1
1International Union Against Tuberculosis and Lung Disease (The Union), Paris, 75006, France.
F1000Research
|July 16, 2019
Summary
Approximately 11% of new tuberculosis (TB) patients registered in India had a prior TB treatment history. This misclassification highlights the need for improved patient screening and program monitoring to ensure accurate TB case management.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- A 2007 Indian study reported 11% misclassification of new tuberculosis (TB) patients.
- Accurate classification of new TB patients is crucial for effective national control programs.
- This study reassessed the proportion of misclassified 'new' TB patients a decade later.
Purpose of the Study:
- To determine the current proportion of newly registered TB patients with a history of prior TB treatment.
- To compare misclassification rates between active and passive TB case-finding strategies.
- To identify factors associated with misclassification in TB patients.
Main Methods:
- A study involving new smear-positive pulmonary TB patients registered between March 2016 and February 2017.
- Inclusion of patients from both active and passive case-finding strategies in 18 randomly selected districts.
- Patient interviews to ascertain history of previous TB treatment (public or private) for at least one month.
Main Results:
- Of 521 interviewed patients, 11% (n=56) had a prior TB treatment history of at least one month.
- Misclassification rates were 13% in the active case-finding group and 9% in the passive case-finding group (p=0.18).
- No specific factors were significantly associated with this misclassification.
Conclusions:
- Approximately one in ten patients registered as 'new' TB cases have a history of previous treatment.
- Implementation of corrective measures and ongoing monitoring are essential for national TB control programs.
- Reducing misclassification improves the accuracy of TB patient data and treatment strategies.
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