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Title: Evaluation and planning in national tuberculosis control programmes: the usefulness of the standardised patient treatment card. Author: Ipuge YA, Rieder HL, Becx-Bleumink M, Kimerling ME. Journal: East Afr Med J; 1997 Dec; 74(12):816-8. PubMed ID: 9557430. Abstract: Through systematic evaluation of information contained in tuberculosis patients treatment cards, we present an example of a rapid operations evaluation method for identifying issues important to a national tuberculosis programme (NTP). Analysis of all 279 treatment cards of patients scheduled to attend one specific clinic day was made ((Kinondoni district in Dar es Salaam, Tanzania). Two hundred and twenty five patients (81%) were diagnosed as having pulmonary tuberculosis. Males accounted for 61% of cases. Ninety two per cent were cases without prior history of treatment. Of all patients, those under 15 years and those aged 25 to 54 years were more likely to be sputum smear-negative compared with other age groups. A chest radiograph was obtained as recommended to support the diagnosis in only 61 (38%) of 160 cases diagnosed as sputum smear-negative pulmonary tuberculosis. Initial drug dosing based on weight (mg/kg) revealed frequent dosing errors of isoniazid (97%) and pyrazinamide (65%), almost exclusively overdosing, in sputum smear-positive patients. Systematic examination of patient treatment cards provided usefull information and raises issues important to NTP planning and operations. Weaknesses in the execution of the national programme in Dar es Salaam were identified: the under-utilisation of chest radiography to diagnose sputum smear-negative tuberculosis and overdosing of certain drugs. The tuberculosis (TB) patient treatment card proposed by the International Union Against Tuberculosis and Lung and Disease provides both patient and protocol-specific information. In addition to data on age and gender, the cards contain information on body weight, drug dosing, sputum smear microscopy results, and the use of chest radiography for diagnosis. All 279 treatment cards of patients scheduled to attend one specific TB clinic day in Kinondoni district, Dar es Salaam, Tanzania, were analyzed as an example of a rapid operations evaluation method for identifying issues important to a national tuberculosis program (NTP). 225 patients were diagnosed with pulmonary TB, of which males comprised 61%. 92% were cases with no prior history of treatment. Patients under age 15 years and those aged 25-54 were more likely than other age groups to be sputum smear-negative. A chest radiograph was obtained to support the diagnosis in 61 of 160 cases diagnosed as sputum smear-negative pulmonary TB. Initial drug dosing based upon patient's weight revealed frequent dosing errors of isoniazid and pyrazinamide in sputum smear-positive patients. Observed error was almost exclusively overdosing.[Abstract] [Full Text] [Related] [New Search]