Journal Article > CommentaryFull Text
Public Health Action. 21 September 2012; Volume 2 (Issue 3); DOI:10.5588/pha.12.0022
Bissell K, Harries AD, Reid A, Edginton ME, Hinderaker SG, et al.
Public Health Action. 21 September 2012; Volume 2 (Issue 3); DOI:10.5588/pha.12.0022
Journal Article > CommentaryFull Text
Public Health Action. 21 September 2013; Volume 3 (Issue 3); DOI:10.5588/pha.13.0066
Harries AD, Kumar AMV, Satyanarayana S, Bissell K, Hinderaker SG, et al.
Public Health Action. 21 September 2013; Volume 3 (Issue 3); DOI:10.5588/pha.13.0066
Journal Article > ResearchFull Text
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 138-41.; DOI:10.5588/pha.12.0034
Ram S, Kishore K, Batio I, Bissell K, Zachariah R, et al.
Public Health Action. 21 December 2012; Volume 2 (Issue 4); 138-41.; DOI:10.5588/pha.12.0034
SETTING
All tuberculosis (TB) diagnostic and treatment centres in Fiji.
OBJECTIVES
To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services.
METHODS
A retrospective review of routine programme data reconciling TB laboratory and treatment registers.
RESULTS
A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001).
CONCLUSION
This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
All tuberculosis (TB) diagnostic and treatment centres in Fiji.
OBJECTIVES
To report on pre-treatment loss to follow-up rates over a 10-year period (2001-2010) and to examine if patients' age, sex and geographic origin are associated with the observed shortcomings in the health services.
METHODS
A retrospective review of routine programme data reconciling TB laboratory and treatment registers.
RESULTS
A total of 690 sputum smear-positive TB patients were diagnosed in the laboratory, of whom 579 (84%) were started on anti-tuberculosis treatment-an overall pre-treatment loss to follow-up of 111 (16%). Peak loss to follow-up rates were seen in 2003, 2004 and 2010. Pre-treatment losses were all aged ≥15 years. In the Western Division of Fiji, 33% of sputum-positive patients were declared pre-treatment loss to follow-up; this division had over five times the risk of such an adverse outcome compared to the Central Division (OR 5.2, 95%CI 3.1-8.9, P < 0.0001).
CONCLUSION
This study has identified an important shortcoming in programme linkage, communication and feedback between TB diagnostic and treatment services, leading to high pre-treatment loss to follow-up rates. This negatively influences TB services, and ways to rectify this situation are discussed.
Journal Article > CommentaryFull Text
Int J Tuberc Lung Dis. 16 June 2012 (Issue 6)
Zachariah R, Harries AD, Srinath S, Ram S, Viney K, et al.
Int J Tuberc Lung Dis. 16 June 2012 (Issue 6)
The words 'defaulter', 'suspect' and 'control' have been part of the language of tuberculosis (TB) services for many decades, and they continue to be used in international guidelines and in published literature. From a patient perspective, it is our opinion that these terms are at best inappropriate, coercive and disempowering, and at worst they could be perceived as judgmental and criminalising, tending to place the blame of the disease or responsibility for adverse treatment outcomes on one side-that of the patients. In this article, which brings together a wide range of authors and institutions from Africa, Asia, Latin America, Europe and the Pacific, we discuss the use of the words 'defaulter', 'suspect' and 'control' and argue why it is detrimental to continue using them in the context of TB. We propose that 'defaulter' be replaced with 'person lost to follow-up'; that 'TB suspect' be replaced by 'person with presumptive TB' or 'person to be evaluated for TB'; and that the term 'control' be replaced with 'prevention and care' or simply deleted. These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm.
Journal Article > Short ReportFull Text
Public Health Action. 21 March 2012; Volume 2 (Issue 1); DOI:10.5588/pha.12.0001
Edginton ME, Enarson D, Zachariah R, Reid AJ, Satyanarayana S, et al.
Public Health Action. 21 March 2012; Volume 2 (Issue 1); DOI:10.5588/pha.12.0001
Journal Article > ResearchFull Text
Building Global Capacity for Conducting Operational Research Using the SORT IT Model: Where and Who?
PLOS One. 9 August 2016; Volume 11 (Issue 8); DOI:10.1371/journal.pone.0160837
Zachariah R, Rust S, Berger SD, Guillerm N, Bissell K, et al.
PLOS One. 9 August 2016; Volume 11 (Issue 8); DOI:10.1371/journal.pone.0160837
Research capacity is weakest in low and middle-income countries (LMICs) where operational research is highly relevant and needed. Structured Operational Research and Training Initiative (SORT IT) courses have been developed to train participants to conduct and publish operational research and influence policy and practice. Twenty courses were completed in Asia, Africa, Europe and the South Pacific between 2009 and 2014.
Journal Article > ResearchFull Text
Trans R Soc Trop Med Hyg. 1 February 2012; Volume 106 (Issue 2); DOI:10.1016/j.trstmh.2011.10.015
Namuwenge P, Mukonzo JK, Kiwanuka N, Wayenze R, Byaruganga R, et al.
Trans R Soc Trop Med Hyg. 1 February 2012; Volume 106 (Issue 2); DOI:10.1016/j.trstmh.2011.10.015
Among HIV-infected adults attending non-governmental organization voluntary counseling and testing (VCT) sites in Uganda that provide a nine-month course of isoniazid preventive treatment (IPT), we report on loss to follow-up (LTFU) and its associated risk factors. The design was a retrospective cohort study of program data spanning a three year period (2006-2008). A total of 586 IPT patients were enrolled of whom 335 (57.1%) were females with a mean age of 34 years. Of those starting IPT, 341 (58.1%) were lost to follow-up, 197 (33.6%) completed IPT, 29 (4.9%) were discontinued and 19 (3.2%) died. The return rates at one, three, five and seven months were 78.0% (457), 62.1% (364), 52.9% (310) and 33.6% (197) respectively. Being less than 30 years of age, widowed, separated, or divorced were found to be associated with a higher risk of loss to follow-up. Sudden improvement in retention on IPT was observed between the years 2006 and 2007, although causes of the improvement are poorly understood hence the need for more research. At non-governmental VCT sites in Uganda, six out of ten individuals enrolled on IPT are lost to follow-up and efforts to reduce this attrition including systems strengthening might play a critical role in the success of IPT programs.
Journal Article > ResearchFull Text
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 63-7.; DOI:10.5588/pha.12.0067
Aiyub S, Linh NN, Tayler-Smith K, Khogali MA, Bissell K
Public Health Action. 21 March 2013; Volume 3 (Issue 1); 63-7.; DOI:10.5588/pha.12.0067
SETTING
Fiji's schools of nursing and government health services, 2001-2010.
OBJECTIVES
To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses.
DESIGN
Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers.
RESULTS
Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation.
CONCLUSION
While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.
Fiji's schools of nursing and government health services, 2001-2010.
OBJECTIVES
To report on 1) the number and characteristics of nurses who graduated in Fiji, 2) the proportion of vacant nursing positions in the government health services and 3) attrition among nurses.
DESIGN
Descriptive study involving a retrospective record review of Ministry of Health annual reports and nursing registers.
RESULTS
Over the period 2001-2010, a total of 1500 nurses graduated, with the overall trend being a gradual increase in newly qualified nurses year on year. Available data from 2007 onwards showed relatively low vacancy rates (range 0.4-2%), with a sharp rise to 15% in 2009. Complete data on nurse attrition were available only from 2007 onwards, with rates of attrition ranging from 4% to 10%; the most common reason for attrition was resignation.
CONCLUSION
While it was unable to directly assess whether Fiji's supply of nursing graduates has been meeting the country's health service demands, this study provides a series of baseline data on Fiji's nurse graduate and nursing workforce. In addition, it identifies some of the challenges and gaps that need to be considered to better assess and address nursing staff shortages.
Journal Article > CommentaryFull Text
Public Health Action. 21 September 2013; Volume 3 (Issue 3); DOI:10.5588/pha.13.0066
Harries AD, Kumar AMV, Satyanarayana S, Bissell K, Hinderaker SG, et al.
Public Health Action. 21 September 2013; Volume 3 (Issue 3); DOI:10.5588/pha.13.0066
Journal Article > Short ReportFull Text
Public Health Action. 21 June 2014; Volume 4 (Issue 1); DOI:10.5588/pha.13.0071
Harries AD, Marais BJ, Kool B, Ram S, Kumar AMV, et al.
Public Health Action. 21 June 2014; Volume 4 (Issue 1); DOI:10.5588/pha.13.0071