PDF(Pubmed)
Abstract：
TB diagnosis has been simplified in India following advances in available diagnostic tools. This facilitates private doctors\' \"patient first\" approach toward early diagnosis; however, costs remain high. India\'s NTEP established a TB diagnostic network, which is free for patients and incentivizes private doctors to participate. Drawing from this context led to the design and implementation of the One-Stop TB Diagnostic Solution model, which was conducted in the Hisar district, Haryana, allowing specimens from presumptive TB patients from private doctors to be collected and tested as per NTEPs diagnostic algorithm. A subset of data pertaining to private doctors was analyzed for the project period. Qualitative data were also collected by interviewing doctors using a snowball method to capture doctors\' perception about the model. Out of 1159 specimens collected from 60 facilities, MTB was detected in 32% and rifampicin resistance was detected in 7% specimens. All specimens went through the diagnostic algorithm. Thirty doctors interviewed were satisfied with the services offered and were appreciative of the program that implements this \"patient centric\" model. Results from implementation indicate the need to strengthen private diagnostics through a certification process to ensure provision of quality TB diagnostic services.
摘要：
随着可用诊断工具的进步，印度的结核病诊断得到了简化。这有助于私人医生“病人优先”的早期诊断方法；然而，成本仍然很高。印度的NTEP建立了结核病诊断网络，这对患者是免费的，并激励私人医生参与。从这一背景出发，设计和实现了一站式结核病诊断解决方案模型，这是在希萨尔区进行的，哈里亚纳邦,允许根据NTEP诊断算法收集和测试来自私人医生的推定结核病患者的标本。在项目期间分析了与私人医生有关的数据子集。还通过使用滚雪球方法采访医生来收集定性数据，以捕获医生对该模型的看法。在从60个设施收集的1159个标本中，在32％的标本中检测到MTB，在7％的标本中检测到利福平抗性。所有标本都通过了诊断算法。接受采访的30名医生对所提供的服务感到满意，并对实施这种“以患者为中心”模式的计划表示赞赏。实施结果表明，需要通过认证过程加强私人诊断，以确保提供高质量的结核病诊断服务。
