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dc.contributor.authorSiddaiah, Archana*
dc.contributor.authorAhmed, Mohammad Naseer*
dc.contributor.authorKumar, Ajay M. V.*
dc.contributor.authorD’Souza, George*
dc.contributor.authorWilkinson, Ewan*
dc.contributor.authorMaung, Thae Maung*
dc.contributor.authorRodrigues, Rashmi*
dc.date.accessioned2019-02-07T11:08:36Z
dc.date.available2019-02-07T11:08:36Z
dc.date.issued2019-02-05
dc.date.submitted2018-05-08
dc.identifierpublisher-id: bmjopen-2018-023910
dc.identifierdoi: 10.1136/bmjopen-2018-023910
dc.identifier.citationBMJ Open, volume 9, issue 2, page bmjopen-2018-023910
dc.identifier.urihttp://hdl.handle.net/10034/621846
dc.descriptionFrom BMJ via Jisc Publications Router
dc.descriptionHistory: received 2018-05-08, rev-recd 2018-10-31, accepted 2018-11-05, ppub 2019-02, epub 2019-02-05
dc.descriptionPublication status: Published
dc.descriptionFunder: Swedish Research Council
dc.descriptionFunder: Department for International Development, FundRef: http://dx.doi.org/10.13039/501100000278
dc.descriptionFunder: Welcome trust/ DBT Alliance
dc.descriptionFunder: La Fondation Veuve Emile Metz-Tesch, Luxumberg
dc.description.abstractObjectives India contributes approximately 25% of the ‘missing’ cases of tuberculosis (TB) globally. Even though ~50% of patients with TB are diagnosed and treated within India’s private sector, few are notified to the public healthcare system. India’s TB notification policy mandates that all patients with TB are notified through Nikshay (TB notification portal). We undertook this study in a private hospital to assess the proportion notified and factors affecting TB notifications. We explored barriers and probable solutions to TB notification qualitatively from health provider’s perspective. Study setting Private, tertiary care, teaching hospital in Bengaluru, South India. Methodology This was a mixed-methods study. Quantitative component comprised a retrospective review of hospital records between 1 January 2015 and 31 December 2017 to determine TB notifications. The qualitative component comprised key informant interviews and focus groups to elicit the barriers and facilitators of TB notification. Results Of 3820 patients diagnosed and treated, 885 (23.2%) were notified. Notifications of sputum smear-positive patients were significantly more likely, while notifications of children were less likely. Qualitative analysis yielded themes reflecting the barriers to TB notification and their solutions. Themes related to barriers were: (1) basic diagnostic procedures and treatment promote notification; (2) misconceptions regarding notification and its process are common among healthcare providers; (3) despite a national notification system other factors have prevented notification of all patients; and (4) establishing hospital systems for notification will go a long way in improving notifications. Conclusions The proportion of patients with TB notified by the hospital was low. A comprehensive approach both by the hospital management and the national TB programme is necessary for improving notification. This includes improving awareness among healthcare providers about the requirement for TB notifications, establishing a single notification portal in hospital, digitally linking hospital records to Nikshay and designating one person to be responsible for notification.
dc.languageen
dc.publisherBMJ Publishing Group
dc.rightsLicense for this article: https://creativecommons.org/licenses/by/4.0/
dc.sourceeissn: 2044-6055
dc.subjectPublic health
dc.subject1506
dc.subject1724
dc.subjectoperational research
dc.subjectTB notification
dc.subjectprivate medical college
dc.subjectmixed-methods research
dc.subjectqualitative research
dc.titleTuberculosis notification in a private tertiary care teaching hospital in South India: a mixed-methods study
dc.typearticle
dc.date.updated2019-02-07T11:08:35Z
dc.date.accepted2018-11-05


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