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261067 A Tuberculosis Program Evaluation at an NGO Hospital in Rural PakistanMonday, October 29, 2012
In 2009 there were an estimated 1.7 million deaths from Tuberculosis(TB) worldwide. Pakistan ranks 6th among the countries with the highest global burden of TB, and contributes about 44% of the burden of TB in the Eastern Mediterranean Region. In order to continue addressing the need for effective TB treatment in Pakistan we sought to examine the quality of care being delivered at a small non-profit hospital in the Khyber Pakhtunkhwa province. This program evaluation was especially timely given the proliferation of DOTS (Directly Observed Therapy-Short course) treatment centers in the area which provide free TB diagnosis, medications and follow-up care. Care was examined in three domains: diagnosis, treatment and follow-up, to DOTS standards. The DOTS standard for TB diagnosis is: 65% of newly diagnosed cases should be AFB positive; at the hospital only 22% of patients diagnosed with TB were AFB positive. In the area of treatment; 91% of patients at the hospital were prescribed an appropriate treatment regimen as outlined by DOTS. The DOTS program involves resource heavy methods to ensure that patients are not lost to follow-up; at the hospital a reminder postcard was sent out to patients, but approximately 30% of patients defaulted on their treatment and are therefore at risk for development of resistant strains of TB. Upon reporting these findings to the hospital it was decided to refer future patients, suspected to have TB, to other treatment centers where they might benefit from greater resources.
Learning Areas:
Conduct evaluation related to programs, research, and other areas of practiceLearning Objectives:
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I completed this TB program evaluation as a student, under the supervision of Dr. John Condie who is a leader at the non-profit hospital. This provided valuable research experience in my education and was also valuable to the hospital in making policy decisions for their TB program.
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
Back to: 3096.0: International / Global Health Student Projects
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