AsianScientist (Oct. 15, 2018) – The quality of tuberculosis (TB) care is lacking in urban India, according to a study published in PLOS Medicine.
Researchers estimate that approximately 40 percent of the population in India is infected with TB, though the majority of these are latent TB infections. The standard of care for Indians displaying TB symptoms and presenting with the disease was previously unknown.
In this study, researchers led by Professor Madhukar Pai of McGill University, Canada, have found that private sector health care providers—the first point of contact for 50-70 percent of patients with TB symptoms in India—are delivering a wide range of largely inadequate care to TB patients.
The researchers analyzed 2,602 standardized patient-provider interactions across 473 Patna providers and 730 Mumbai providers and found that providers managed standardized patient cases according to national and international standards in only 35 percent of interactions, after weighting for city-representative interpretation.
They also found that allopathic providers with bachelor of medicine, bachelor of surgery (MBBS) degrees or higher were more likely to correctly manage cases than non-MBBS providers.
However, within each qualification stratum, the researchers reported a wide range of treatment quality and multiple treatment protocols. They also found that providers stick to their often-erroneous protocols, repeating their own observed actions 75 percent of the time. Providers were also more likely to manage a case correctly when they were presented with more diagnostic information.
The authors noted that standardized patients are not reflective of the broader mix of patients a provider sees; the study also did not assess how a provider might manage a patient in subsequent visits. Nevertheless, they highlighted that these results indicate that improving TB management among urban India’s private health sector should be a priority for India’s TB elimination strategy.
The article can be found at: Kwan et al. (2018) Variations in the Quality of Tuberculosis Care in Urban India: a Cross-sectional, Standardized Patient Study in Two Cities.
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Source: PLOS; Photo: Shutterstock.
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