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The referral pathway of presumptive drug-resistant tuberculosis in an urban poor setting The Philippines

机译：菲律宾城市贫困地区推定耐药性结核病的转诊途径

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>Setting: Socio-economically underprivileged urban areas in the Philippines.>Objectives: To identify gaps in the referral pathway of presumptive drug-resistant tuberculosis (DR-TB) patients from initial consultation until initiation of treatment.>Design: A retrospective study in which a masterlist of presumptive multidrug-resistant TB (MDR-TB) patients registered in 18 DOTS facilities in Tondo, Manila and Payatas, Quezon City, from October 2012 to September 2013, was analysed and reviewed.>Results: Among 378 presumptive DR-TB patients identified and listed in the masterlist, 97% (368/378) were referred, of whom 90% (333/368) were screened at an MDR-TB treatment centre. Of the 368 patients, 35 (9.5%) were not screened, mainly due to loss to follow-up. Among those screened, 86.4% (288/333) were recommended for anti-tuberculosis treatment, of whom 98.2% (283/288) initiated treatment. The time between sample collection and examination was significantly longer at the laboratories of non-government organisations (NGOs) than at local government units (LGUs) (1 day vs. 0 day; P < 0.001). The time to the release of smear examination results to patients was significantly shorter at the NGOs than at the LGUs (4 days vs. 6 days; P = 0.009).>Conclusion: The development of the presumptive MDR-TB masterlist facilitated tracking of patients for diagnosis and treatment. The NGOs should reduce delays in diagnosis and the LGUs should intensify patient follow-up to ensure early initiation of treatment.
机译：>设置：菲律宾的社会经济贫困城市地区。>目标：从初步咨询中找出推定的耐药结核病（DR-TB）患者转诊途径中的差距直到开始治疗。>设计：一项回顾性研究，该研究从10月开始在马尼拉Tondo，奎松市Payatas的18个DOTS设施中登记了多药耐药性结核病（MDR-TB）推测患者名单分析并审查了2012年至2013年9月的结果。>结果：在鉴定并列入主列表的378名推定性DR-TB患者中，有97％（368/378）被转诊，其中90％（333 / 368）在耐多药结核病治疗中心进行了筛查。在368例患者中，有35例（9.5％）未接受筛查，主要是由于随访失败。在筛查的人群中，推荐86.4％（288/333）用于抗结核治疗，其中98.2％（283/288）开始抗结核治疗。在非政府组织（NGOs）的实验室中，从样本收集到检查的时间比在地方政府部门（LGUs）中的时间显着更长（1天vs. 0天； P <0.001）。 NGOs向患者发布涂片检查结果的时间比LGUs显着缩短（4天比6天； P = 0.009）。>结论：推定的MDR-结核病大师名单有助于追踪患者的诊断和治疗。非政府组织应减少诊断延迟，LGU应加强对患者的随访，以确保尽早开始治疗。

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