Spatial Disparity in Availability of Tuberculosis Diagnostic Services Based on Sector and Level of Care in Nigeria

作     者：Bethrand Odume Sani Useni Egwuma Efo Degu Dare Elias Aniwada Nkiru Nwokoye Ogoamaka Chukwuogo Chidubem Ogbudebe Michael Sheshi Aminu Babayi Emperor Ubochioma Obioma Chijioke-Akaniro Chukwumah Anyaike Rupert Eneogu Debby Nongo Bethrand Odume;Sani Useni;Egwuma Efo;Degu Dare;Elias Aniwada;Nkiru Nwokoye;Ogoamaka Chukwuogo;Chidubem Ogbudebe;Michael Sheshi;Aminu Babayi;Emperor Ubochioma;Obioma Chijioke-Akaniro;Chukwumah Anyaike;Rupert Eneogu;Debby Nongo

作者机构：KNCV Nigeria Abuja Nigeria KNCV Netherlands The Hague Netherlands Department of Community Medicine University of Nigeria Nsukka Nigeria NTBLCP FMOH Abuja Nigeria USAID Abuja Nigeria 

出 版 物：《Journal of Tuberculosis Research》 (结核病研究（英文）)

年 卷 期：2023年第11卷第1期

页      面：12-22页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Tuberculosis Diagnostic Services Disparity Sector Level Nigeria 

摘      要：Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic services across the health system.