Tuberculosis cure rates and the ETR.Net: investigating the quality of reporting treatment outcomes from primary healthcare facilities in Mpumalanga province, South Africa.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Tuberculosis/*prevention & control; Cross-Sectional Studies ; Data Accuracy ; Humans ; Primary Health Care/statistics & numerical data ; South Africa/epidemiology ; Treatment Outcome ; Tuberculosis/epidemiology

Background: Tuberculosis control programs rely on accurate collection of routine surveillance data to inform program decisions including resource allocation and specific interventions. The electronic TB register (ETR.Net) is dependent on accurate data transcription from both paperbased clinical records and registers at the facilities to report treatment outcome data. The study describes the quality of reporting of TB treatment outcomes from facilities in the Ehlanzeni District, Mpumalanga Province.
Methods: A descriptive crossectional study of primary healthcare facilities in the district for the period 1 January - 31 December 2010 was performed. New smear positive TB cure rate data was obtained from the ETR.Net followed by verification of paperbased clinical records, both TB folders and the TB register, of 20% of all new smear positive cases across the district for correct reporting to the ETR.Net. Facilities were grouped according to high (>70%) and low cure rates (≤ 70%) as well as high (> 20%) and low (≤ 20%) error proportions in reporting. Kappa statistic was used to determine agreement between paperbased record, TB register and ETR.Net.
Results: Of the100 facilities (951 patient clinical records), 51(51%) had high cure rates and high error proportions, 14(14%) had a high cure rate and low error proportion whereas 30(30%) had low cure rates and high error proportions and five (5%) had a low cure rate with low error proportion. Fair agreement was observed (Kappa = 0.33) overall and between registers. Of the 473 patient clinical records which indicated cured, 383(81%) was correctly captured onto the ETR.Net, whereas 51(10.8%) was incorrectly captured and 39(8.2%) was not captured at all. Over reporting of treatment success of 12% occurred on the ETR.Net.
Conclusions: The high error proportion in reporting onto the ETR.Net could result in a false sense of improvement in the TB control programme in the Ehlanzeni district.

Public Health Action. 2015 Jun 21;5(2):122-6. (PMID: 26400383)
BMC Public Health. 2015 Aug 11;15:765. (PMID: 26259599)
Eur Respir J Suppl. 2002 Jul;36:66s-77s. (PMID: 12168749)
Fam Med. 2005 May;37(5):360-3. (PMID: 15883903)
Int J Tuberc Lung Dis. 2011 Mar;15(3):337-43. (PMID: 21333100)
Int J Tuberc Lung Dis. 2005 Apr;9(4):398-402. (PMID: 15830744)
Tuberculosis (Edinb). 2013 Sep;93(5):567-8. (PMID: 23769141)
J Health Popul Nutr. 2010 Feb;28(1):7-13. (PMID: 20214081)
Int J Tuberc Lung Dis. 2008 Aug;12(8):936-41. (PMID: 18647454)
Public Health Action. 2011 Sep 21;1(1):19-24. (PMID: 26392930)
Int J Tuberc Lung Dis. 2013 Oct;17(10):1317-21. (PMID: 24025384)

Keywords: ETR.Net; Quality of data; Treatment outcome

Date Created: 20170312 Date Completed: 20170828 Latest Revision: 20181202

20240829

PMC5345238

10.1186/s12913-017-2128-0

28283037