Health systems performance in managing tuberculosis
Analysis of tuberculosis care cascades among high-burden and non-high-burden countries
Bibliographic Data
| ID | 19551448 |
|---|---|
| Authors | Jungyeon Kim (0000-0003-1509-0240, Harvard Global Health Institute), Salmaan Keshavjee (0000-0002-6967-3305, Harvard University), Rifat Atun (0000-0002-1531-5983, Harvard University, corresponding author) |
| Year | 2019 |
| Volume | 9 |
| Issue | 1 |
| Pages | 010423-010423 |
| Publication date | 2019-06-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Journal of Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2047-2978 • E-ISSN: 2047-2986 |
| Publisher | International Society of Global Health (PUBLISHER • GB) |
| DOI | 10.7189/jogh.09.010423 |
| PMID | 31263546 |
| OpenAlex | W2924383291 |
| Language | EN |
| Citations received | 4 |
| References cited | 18 |
BACKGROUND: Tuberculosis (TB) is a major global health burden, which has been inadequately addressed. This study aims to analyze different patterns and gaps of care along the care cascade across countries and to develop a model to examine the relationship between performance of tuberculosis programmes in high and low burden countries along the tuberculosis care cascade and tuberculosis disease burden. METHODS: We used the World Health Organization's Global TB Database for the year 2016 to construct tuberculosis care cascade consisting of four steps: incidence, diagnosed, treatment started and treatment completed. Based on the constructed care cascades, we analyzed the relationship between health system performance indicators and tuberculosis cascades performance: diagnosed rate, treatment started rate, and treatment completed rate. RESULTS: There are wide differences in access to diagnosis and treatment between high-burden countries and non-high-burden countries. The largest gap was found between incidence and diagnosed rate, with 65% of diagnosed rate for high burden countries and 80% of diagnosed rate for non-high burden countries. We found variations in care performance among high-burden countries. We found a negative relationship between the population health indicators related to the mortality rate and TB care cascade performance. There was a positive relationship between immunization coverage rate and antenatal care indicators and TB care cascade performance. CONCLUSIONS: Well-functioning tuberculosis care cascades and effective health systems are important for the successful management of tuberculosis. While improving screening performance is essential for tuberculosis control especially for high-burden countries, resource should be allocated to improve health system performance, which is weak in high-burden countries. Performance of TB programmes across care cascade could be used as a useful tracer to measure performance of health systems
Burden of disease · Developing country · Disease burden · Economic growth · Environmental health · Health care · Mortality rate · Population · Public health · Tuberculosis · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Nursing · Tuberculosis Research and Epidemiology · Internal Medicine
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| Unique citing works | 4 |
|---|---|
| Citations per year | 1,33 |
| Citation span | 2023 - 2025 (3) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 3 |