"Together against tuberculosis": Cascade of care of patients referred by the private health care providers in the Kyrgyz Republic

• Published in: Tropical medicine and infectious disease Vol. 8; no. 6; pp. 1 - 14
• Main Authors: Madybaeva, Dinara, Duishekeeva, Aiymgul, Meteliuk, Anna, Kulzhabaeva, Aizat, Kadyrov, Abdullaat, Shumskaia, Natalia, Kumar, Ajay M V
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland MDPI 01.06.2023; MDPI AG
• Subjects: Analysis; Antibiotics; Care and treatment; Cities; Clinical outcomes; COVID-19; Diagnosis; Disease transmission; Evaluation; failure; Global health; Health care industry; Health facilities; key population; Kyrgyz Republic; Laboratories; Medical diagnosis; Medical research; Medicine, Experimental; Microscopy; operational research; Patients; Prevention; Public health; Public sector; Radiography; Services for; SORT IT; TB presumptive; Transmission; Treatment; Tuberculosis; Kyrgyzstan; India; Central Asia; Kyrgyz Republic; SORT IT; private sector; failure; operational research; key population; TB presumptive
• ISSN: 2414-6366; 2414-6366
• DOI: 10.3390/tropicalmed8060316

Until 2021, in the Kyrgyz Republic, tuberculosis (TB) was diagnosed and treated only in the public sector. With funding support of the STOP-TB partnership, the private providers in four regions of the country and Bishkek city were mapped, trained and incentivized to screen for and identify presumptive TB patients and refer them to the public facilities for diagnosis and treatment. In this study, we describe the cascade of care of such patients. This was a cohort study involving secondary analysis of routine data. Of 79,352 patients screened during February 2021-March 2022, 2511 (3%) had presumptive TB, of whom 903 (36%) were not tested for TB [pre-diagnostic loss to follow-up]. A total of 323 (13%) patients were diagnosed with TB, of whom, 42 (13%) were not started on treatment [pre-treatment loss to follow-up]. Among 257 patients eligible for outcome assessment, 197 (77%) had treatment success, 29 (11%) were lost-to-follow-up, 13 (5%) died, 4 (2%) had treatment failure and 14 (5%) were not evaluated. While this donor-funded, pioneering initiative was successful in engaging the private sector, we recommend that the national TB programme scales up the initiative nationally with dedicated budgets, activities and plans to monitor progress. Qualitative research is urgently needed to understand the reasons for the gaps in the care cascade.