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008			221122b xxu||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_9264 _aMorales Cartagena, Cristina Alejandra _eMedicina Interna
245	0	0	_aImplementation challenges of a TB programme in rural northern mozambique: evaluation of 2012-2013 outcomes. _h[artículo]
260			_bPathogens and global health, _c2015
300			_a109(5):221-7.
500			_aFormato Vancouver: Wikman Jorgensen PE, Morales Cartagena A, Llenas García J, Pérez Porcuna TM, Hobbins M, Ehmer J et al. Implementation challenges of a TB programme in rural northern mozambique: evaluation of 2012-2013 outcomes. Pathog Glob Health. 2015 Jul;109(5):221-7.
501			_aPMID: 26239760 PMC4727574
504			_aContiene 35 referencias
520			_aBackground: We aimed to identify challenges and to propose solutions for the implementation of tuberculosis (TB) programmes in rural Sub-Saharan Africa (SSA) by evaluating the outcomes of the TB programme in the Ancuabe district in rural Northern Mozambique. Methods: Retrospective descriptive study of the patients included in the TB programme in 2012-2013. Follow-up was continued till June 2014. Results: Three hundred nineteen patients were registered, 62.1% male, mean age 36.3 (SD 14.4), estimated case detection rate (eCDR) of 24.24%. Two hundred seventy-two were new cases, 21 transferred-in, 11 back after lost to follow-up (LTFU), 10 relapsing TB, 5 previous treatment failures. 94.4% were tested for Human immunodeficiency virus (HIV), 41.9% HIV-positive. 87.5% of the new cases were pulmonary TB (PTB), 43.4% were HIV co-infected. Initial sputum results were available in 207 cases, with 145 smear-positive (SP) cases. Outcomes of new cases: 122 (44.9%) LTFU, 55 (20.2%) cured, 43 (15.8%) treatment completed (98-36%-treatment success), 31 (11.4%) died, 19 (7%) transferred out and 2 (0.7%) failures. Conclusions: A low eCDR and high proportion of LTFU demonstrate that few patients were identified and had a low probability of complete treatment, suggesting a fragile health system. This raises the hypothesis that, probably, to improve TB health care in rural SSA, interventions should aim at improving health systems. Special attention should be given to social protection and compensation of the financial burden associated with TB.
710			_96 _aServicio de Medicina Interna
856			_u https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4727574/ _yAcceso libre
942			_2ddc _cART _n0