Tools to identify referral sources of TB patients

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Tools to identify referral sources of TB patients

• MOH - NTP
• Dr. FADIA MAAMARI
• SYRIA ARAB REPUBLIC
• NTP managers meeting
• Damascus - SEP 2002

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outpatients register

• Definition
• It is a register used in registration section in
  TB center to register all the new attendants (TB
  suspects), that are referred to the center for
  diagnosis.
• Candidates for registration
• 1- A person with chest symptoms for more than
  three weeks
• 2- Extra-pulmonary TB cases that are diagnosed
  out of the center.

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• Sources of the patients
• Usually the patients come by themselves or they
  are referred to the center from (general
  hospitals, private hospitals, military
  hospitals, private clinics, contacts, themselves,
  prisons, police).

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Composition of outpatient register

• The register is composed of 10 columns named as
  
  
• serial number
• Name/surname
• father's name
• Age
• sex
• Complete address
• Referred from
• Requested examinations (tuberculin test, X-ray,
  Sputum)
• Result (tuberculin test, X-ray, Sputum)
• Remarks

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Results

• The results of registration on the out patients
  register in all provinces for the year 2001 were
  analyzed to have an idea about the role of
  different sectors contribution to case finding
  of Tb cases.
• A total of 14806 attendants were entered in out
  patient register in all TB centers during 2001 in
  Syria, out of them 12709 were chest symptomatics.
  

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Breakdown of chest symptomatics according to
source of reference
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Provincial/District register

• Definition
• The province/district tuberculosis register is
  the record of TB cases that were diagnosed as TB
  patients and enrolled on treatment for TB.
• It is very important to register every patient
  who starts treatment for tuberculosis and record
  the relevant information for all patients. From
  this register we can know the referring source of
  patients.
• Candidates for registration
• All types of TB cases enrolled on treatment

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Composition of TB register

• It contains the following columns
• Date
• Patient code
• Complete name
• Sex
• Age
• Complete Address
• Referred from
• Regimens and start date of treatment
• Disease classification
• Follow up sputum tests
• Treatment results
• Remarks

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Results

• All TB patients notified and registered in 2001
  were analyzed to identify the source of
  reference.
• Total Patients analyzed were 4905 in 2001, out
  of them there are 1490 smear positive TB
  patients, 1318 TB patients smear negative, 2097
  TB patients extra pulmonary.

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Breakdown of TB patients according to source of
reference
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Conclusion and Recommendation

• If we arrange the sources of suspects/patients
  according to its contribution to the total number
  of suspects/patients we can see that the main
  bulk of suspects/patients are from private
  clinics(33), contacts examination (30), self
  reporting (16), police medical services and
  health centers (6.9, 7), general hospitals (6).
  The referred suspects from military services are
  around 2.
• Accordingly it is recommended to increase the
  active case finding among contacts as a high risk
  group, strengthen the notification from private
  sector, increase awareness among health workers
  in health centers and general hospitals to
  identify suspects.