Setting
Tuberculosis (TB) Basic Management Unit at Kavieng Provincial Hospital, New Ireland Province, PNG
Objective
To assess the linkage between laboratory diagnosis and treatment commencement, and describe the characteristics and treatment outcomes of TB patients
Design
A retrospective cohort study of: 1) sputum smear-positive TB cases recorded in the laboratory register and 2) TB cases recorded in the treatment register at Kavieng Basic Management Unit in 2015 and 2016
Results
Twelve (21%) of 58 sputum smear-positive TB cases were not registered as being treated for TB. Of the 221 patients registered for TB treatment over the two-year period, 173 (78%) were clinically diagnosed and extrapulmonary TB was common (36% of all cases). Unfavorable treatment outcomes were common including death (10%) and lost to follow-up (26%), and was significantly more common in smear-negative compared to smear-positive pulmonary TB cases (OR 2.35 (95% CI 1.09-5.06)). Only 4 (<2%) TB cases had been tested for HIV.
Conclusion
This study identifies diagnostic and treatment gaps in the TB treatment cascade at Kavieng Basic Management Unit. The TB program requires strengthening to address the high proportion of clinically diagnosed TB and patients not tested for HIV.
