Anila Basit, Mazher Ali Khan, Mohammed Dost, Mubasher Ahmad, Ziaullah, Zafar Iqbal, Nafees Ahmed, Yousaf Khan, Shazia, Rubina, Arshad Javaid.
Need for Establishing a Linkage Between Tertiary Care Hospitals and Peripheral DOTS Centers.
Pak J Chest Med Jan ;19(3):99-103.

Background: Despite gradual improvement in recent years, Pakistan is still lagging behind in achieving the global target of tuberculosis (TB) case detection rate. The absence of referral systems of TB patients diagnosed in wards of tertiary hospitals may be one of the reasons. Objective: To assess the number of TB patients diagnosed in pulmonology department of a teaching hospital and refer them to their nearby treatment centers. Methods: This was a cross sectional study conducted from March 2009 to October 2009 at pulmonology unit of Lady Reading Hospital, Peshawar. All patients diagnosed as active TB patients presented to Pulmonology department were included. Patients’ data including age, sex, address, type and site of TB and sputum status were noted. On discharge the patients outside from hospital catchment area were referred to their respective nearby health centers. Results: A total 785 patients were diagnosed as TB in a period of 8 months. One hundred and twenty two patients were suspects of drug resistance TB and were excluded from the study. Among the studied 663 patients, 227 (34.23%) diagnosis were made in chest ward while 436 (65.76%) were made in outpatient department (OPD). Among them, 638 (96.2%) were new TB cases and 364 (55%) suffered from pulmonary TB. All 227 patients diagnosed in the chest ward were from the areas outside hospital catchment area and were referred to their respective nearby DOTS centers. Out of 436 TB patients diagnosed in OPD 254 (57.3%) patients were from outside the hospital catchment area and were referred to their nearby DOTS centers. Conclusion: The number of TB patients diagnosed and referred from ward to their respective districts is almost equal to the number of patients referred from OPD. As no integrated referral system for diagnosed TB cases exists in wards of tertiary hospitals, there is high probability of initial default.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com