2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment
BACKGROUND: In Pakistan, 84% of healthcare is provided by the private sector. We conducted an epidemiological and programme review for TB to document progress and guide further efforts. METHODS: Surveillance and data systems were assessed before analysing epidemiological data. We reviewed the progra...
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-03-01
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| author | M. van den Boom K. Bennani C. Sismanidis C. Gunneberg L. Khawaja M.A. Safdar C. Muhwa E. Heldal D.M. Cirillo A.W. Khan R. Fatima B.J. Khan S. Tahseen M.G. ElMedrek Y. Hutin Pakistan Joint TB Program Review Mission |
| author_facet | M. van den Boom K. Bennani C. Sismanidis C. Gunneberg L. Khawaja M.A. Safdar C. Muhwa E. Heldal D.M. Cirillo A.W. Khan R. Fatima B.J. Khan S. Tahseen M.G. ElMedrek Y. Hutin Pakistan Joint TB Program Review Mission |
| author_sort | M. van den Boom |
| collection | DOAJ |
| description | BACKGROUND: In Pakistan, 84% of healthcare is provided by the private sector. We conducted an epidemiological and programme review for TB to document progress and guide further efforts. METHODS: Surveillance and data systems were assessed before analysing epidemiological data. We reviewed the programme at federal, provincial and peripheral levels and compiled national data along with WHO estimates to describe the evolution of epidemiological and programme indicators. RESULTS: In 2021, of the estimated number of TB cases, 55% of overall cases and 18% of drug-resistant cases were diagnosed and treated respectively. The contribution of the private sector in case detection increased from 30% in 2017 to 40% by 2021. For newly diagnosed pulmonary TB cases, the overall proportion of confirmed cases was 52%. In 2021, testing for rifampicin resistance among confirmed cases was 66% for new and 84% for previously treated patients. The treatment success rate exceeded 90% for drug susceptible TB. The main challenges identified were a funding gap (60% in 2021–2023), fragmented electronic systems for data collection and suboptimal coordination among provinces. CONCLUSIONS: The main challenges prevent further progress in controlling TB. By addressing these, Pakistan could improve coverage of interventions, including diagnosis and treatment. Bacteriological confirmation using recommended diagnostics also requires further optimisation. |
| format | Article |
| id | doaj-art-65d6d43b7f1f4e51876d68df49043cb4 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-65d6d43b7f1f4e51876d68df49043cb42025-01-21T10:35:34ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-03-011313614310.5588/ijtldopen.23.058762022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatmentM. van den Boom0K. Bennani1C. Sismanidis2C. Gunneberg3L. Khawaja4M.A. Safdar5C. Muhwa6E. Heldal7D.M. Cirillo8A.W. Khan9R. Fatima10B.J. Khan11S. Tahseen12M.G. ElMedrek13Y. Hutin14Pakistan Joint TB Program Review MissionWorld Health Organization (WHO), Regional Office for the Eastern Mediterranean Region, Cairo, Egypt;World Health Organization (WHO), Regional Office for the Eastern Mediterranean Region, Cairo, Egypt;WHO, Geneva, Switzerland;WHO, Geneva, Switzerland;WHO, Country Office for Pakistan, Islamabad, Pakistan;WHO, Country Office for Pakistan, Islamabad, Pakistan;Respiratory Society of Kenya, Kenya;Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway;Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy;Pakistan Ministry of National Health Services, Regulations & Coordination, Government of Pakistan, Islamabad, PakistanPakistan Ministry of National Health Services, Regulations & Coordination, Government of Pakistan, Islamabad, PakistanPakistan Ministry of National Health Services, Regulations & Coordination, Government of Pakistan, Islamabad, PakistanPakistan Ministry of National Health Services, Regulations & Coordination, Government of Pakistan, Islamabad, PakistanWorld Health Organization (WHO), Regional Office for the Eastern Mediterranean Region, Cairo, Egypt;World Health Organization (WHO), Regional Office for the Eastern Mediterranean Region, Cairo, Egypt;BACKGROUND: In Pakistan, 84% of healthcare is provided by the private sector. We conducted an epidemiological and programme review for TB to document progress and guide further efforts. METHODS: Surveillance and data systems were assessed before analysing epidemiological data. We reviewed the programme at federal, provincial and peripheral levels and compiled national data along with WHO estimates to describe the evolution of epidemiological and programme indicators. RESULTS: In 2021, of the estimated number of TB cases, 55% of overall cases and 18% of drug-resistant cases were diagnosed and treated respectively. The contribution of the private sector in case detection increased from 30% in 2017 to 40% by 2021. For newly diagnosed pulmonary TB cases, the overall proportion of confirmed cases was 52%. In 2021, testing for rifampicin resistance among confirmed cases was 66% for new and 84% for previously treated patients. The treatment success rate exceeded 90% for drug susceptible TB. The main challenges identified were a funding gap (60% in 2021–2023), fragmented electronic systems for data collection and suboptimal coordination among provinces. CONCLUSIONS: The main challenges prevent further progress in controlling TB. By addressing these, Pakistan could improve coverage of interventions, including diagnosis and treatment. Bacteriological confirmation using recommended diagnostics also requires further optimisation.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000003/art00006tuberculosisdrug resistanceprevention/control programmenational tuberculosis programme |
| spellingShingle | M. van den Boom K. Bennani C. Sismanidis C. Gunneberg L. Khawaja M.A. Safdar C. Muhwa E. Heldal D.M. Cirillo A.W. Khan R. Fatima B.J. Khan S. Tahseen M.G. ElMedrek Y. Hutin Pakistan Joint TB Program Review Mission 2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment IJTLD Open tuberculosis drug resistance prevention/control programme national tuberculosis programme |
| title | 2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment |
| title_full | 2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment |
| title_fullStr | 2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment |
| title_full_unstemmed | 2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment |
| title_short | 2022 TB programme review in Pakistan: strengthening governance, with better patient diagnosis and treatment |
| title_sort | 2022 tb programme review in pakistan strengthening governance with better patient diagnosis and treatment |
| topic | tuberculosis drug resistance prevention/control programme national tuberculosis programme |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000003/art00006 |
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