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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/8719| Private sector tuberculosis care quality during the COVID-19 pandemic: A repeated cross-sectional standardized patients study of adherence to national TB guidelines in urban Nigeria | |
| Angelina Sassi Lauren Rosapep Elaine Baruwa Bolanle Olusola-Faleye Ben Johns Mohammad Abdullah Heel Kafi Lavanya Huria Nathaly Aguilera Vasquez Benjamin Daniels Jishnu Das Chukwuma ANYAIKE Obioma Chijioke-Akaniro Madhukar Pai Charity Omenka | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| https://doi.org/10.1101/2024.02.17.24302708 | |
| https://www.medrxiv.org/content/10.1101/2024.02.17.24302708v1 | |
| Only a third of TB cases in Nigeria in 2020 were diagnosed and notified, in part due to low detection and underreporting from the private health sector. Using a standardized patient (SP) survey approach, we assessed how management of presumptive TB in the private sector aligns with national guidelines and whether this differed from a study conducted before the start of the COVID-19 pandemic. Thirteen standardized patients presented a presumptive TB case to 511 private providers in urban areas of Lagos and Kano states in May and June 2021. Private provider case management was compared with national guidelines divided into three main steps: SP questioned about cough duration; sputum collection attempted for TB testing; and non-prescription of anti-TB medications, antibiotics, and steroids. SP visits conducted in May-June 2021 were directly compared to SP visits conducted in the same areas in June-July 2019. Overall, only 145 of 511 (28%, 95% CI: 24.5–32.5%) interactions were correctly managed according to Nigerian guidelines, as few providers completed all three necessary steps. Providers in 71% of visits asked about cough duration (362 of 511, 95% CI: 66.7–74.7%), 35% tested or recommended a sputum test (181 of 511, 95% CI: 31.3–39.8%), and 79% avoided prescribing or dispensing unnecessary medications (406 of 511, 95% CI: 75.6–82.8%). COVID-19 related questions were asked in only 2.4% (12 of 511, 95% CI: 1.3–4.2%) of visits. During the COVID-19 pandemic, few providers completed all steps of the national guidelines. Providers performed better on individual steps, particularly asking about symptoms and avoiding prescription of harmful medications. Comparing visits conducted before and during the COVID-19 pandemic showed that COVID-19 did not significantly change the quality of TB care | |
| bioRxiv | |
| 20-02-2024 | |
| Preimpreso | |
| Inglés | |
| Público en general | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Materiales de Consulta y Comunicados Técnicos |
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