Abstract
The performance of the tuberculosis (TB) programme should be judged on the basis of detected TB cases recorded in the laboratory register and not just those placed on treatment and recorded in the TB treatment register. We examined the performance of the TB programme in this regard in Kyrgyzstan in 2012. This retrospective cohort study included all sputum smear-positive pulmonary TB cases registered in the TB laboratory register (584 persons). Data variables on geographical region, TB diagnosis, TB treatment and outcomes were sourced from various registers. We analysed (1) initial lost to follow-up (LTfu) between urban and rural areas; (2) time of starting treatment after diagnosis; (3) treat-
ment outcomes of laboratory-registered and treatment-registered patients. Of 584 patients diagnosed with new smear-positive pulmonary TB in two cities and eight rural districts, 59 (10%) were not traced in the patient TB treatment register and considered as initial LTfu. rural areas had significantly higher initial LTfu (13%) compared with urban areas (8%). The mean time to initiating treatment among those who were entered
in the TB register was 14 days (range 8–28 days). When all TB cases included in the laboratory register were used as the denominator, the overall treatment success rate reduced from 75% to 67% (a drop of 8%). Reporting on TB programme outcomes without including initial LTfu tends to exaggerate TB programme performance. Concerted efforts are needed to limit initial LTfu and accelerate progress towards ending TB as a
public health problem.
