Engagement of public and private medical facilities in tuberculosis care in Myanmar:contributions and trends over an eight-year period

作     者：Thin Thin Nwe Saw Saw Le Le Win Myo Myo Mon Johan van Griensven Shuisen Zhou Palanivel Chinnakali Safieh Shah Saw Thein Si Thu Aung Nwe Thin Thin;Saw Saw;Win Le Le;Mon Myo Myo;Griensven Johan van;Zhou Shuisen;Chinnakali Palanivel;Shah Safieh;Thein Saw;Aung Si Thu

作者机构：Procurement UnitDepartment of Public HealthNaypyitawMyanmar Department of Medical ResearchYangonMyanmar Institute of Tropical MedicineAntwerpBelgium Institute of Parasitic DiseasesChinese Center for Disease Control and PreventionShanghaiChina Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)PuducherryIndia Operational Research Unit(LuxOR)MEdecins Sans FrontiEres-Operational Centre BrusselsLuxembourgLuxembourg National TB ProgramDepartment of Public HealthNaypyitawMyanmar Procurement and Supply DivisionDepartment of Public HealthMinistry of HealthNaypyitawMyanmar 

出 版 物：《Infectious Diseases of Poverty》 (贫困所致传染病（英文）)

年 卷 期：2017年第6卷第1期

页      面：1083-1089页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：The program was funded by WHO/TDR Impact grant to two TDR alumni from DMR.The funders had no role in study design data collection and analysis decision to publish or preparation of the manuscript 

主　　题：Public and private Tuberculosis Myanmar Operational research 

摘      要：Background:As part of the WHO End TB strategy,national tuberculosis(TB)programs increasingly aim to engage all private and public TB care *** of communities,civil society organizations and public and private care provider is the second pillar of the End TB *** Myanmar,this entails the public-public and public-private mix(PPM)*** public-public mix refers to public hospital TB services,with reporting to the national TB program(NTP).The public-private mix refers to private general practitioners providing TB services including TB diagnosis,treatment and reporting to *** aim of this study was to assess whether PPM activities can be scaled-up nationally and can be sustained over ***:Using 2007-2014 aggregated program data,we collected information from NTP and non-NTP actors on 1)the number of TB cases detected and their relative contribution to the national case load;2)the type of TB cases detected;3)their treatment ***:The total number of TB cases detected per year nationally increased from 133,547 in 2007 to 142,587 in *** contribution of private practitioners increased from 11%in 2007 to 18%in 2014,and from 1.8%to 4.6%for public *** NTP contribution decreased from 87%in 2007 to 77%in 2014.A similar pattern was seen in the number of new smear(+)TB cases(31%of all TB cases)and retreatment cases,which represented 7.8%of all TB *** new smear(+)TB cases,adverse outcomes were more common in public hospitals,with more patients dying,lost to follow up or not having their treatment outcome *** treated by private practitioners were more frequently lost to follow up(8%).Adverse treatment outcomes in retreatment cases were particularly common(59%)in public hospitals for various reasons,predominantly due to patients dying(26%)or not being evaluated(10%).In private clinics,treatment failure tended to be more common(8%).Conclusions:The contribution of non-NTP actors to TB detection at the