4.1 Article

High initial default in patients with smear-positive pulmonary tuberculosis at a regional hospital in Accra, Ghana

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.trstmh.2012.05.002

Keywords

Ghana; TB; Initial defaulters; Laboratory register; Treatment register

Funding

  1. Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, France
  2. Operational Research Unit, Medecins sans Frontieres, Brussels Operational Centre, Luxembourg
  3. National TB Control Programme, Accra, Ghana

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Sputum smear-positive TB patients, diagnosed in the laboratory, who never start anti-TB treatment are classified as 'initial defaulters'. In Ridge Hospital, Accra, Ghana, there were 84 laboratory confirmed TB cases in 2009, of whom 32 (38%) were initial defaulters. Cure and default rates based on this cohort were 54% and 43% respectively, compared with rates of 87% and 8% when using the cohort based on 52 patients registered for treatment. This study highlights the problem of initial defaulters, and shows that programme performance may be poor when patients in laboratory registers are used as the cohort to evaluate treatment outcomes. (C) 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

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