Constructing care cascades for active tuberculosis: A strategy for program monitoring and identifying gaps in quality of care
Author(s)
Subbaraman, Ramnath
Nathavitharana, Ruvandhi R
Mayer, Kenneth H
Satyanarayana, Srinath
Chadha, Vineet K
Type
Journal Article
Abstract
The cascade of care is a model for evaluating patient retention across sequential stages of care required to achieve a successful treatment outcome. This approach was first used to evaluate HIV care and has since been applied to other diseases. The tuberculosis (TB) community has only recently started using care cascade analyses to quantify gaps in quality of care. In this article, we describe methods for estimating gaps (patient losses) and steps (patients retained) in the care cascade for active TB disease. We highlight approaches for overcoming challenges in constructing the TB care cascade, which include difficulties in estimating the population-level burden of disease and the diagnostic gap due to the limited sensitivity of TB diagnostic tests. We also describe potential uses of this model for evaluating the impact of interventions to improve case finding, diagnosis, linkage to care, retention in care, and post-treatment monitoring of TB patients.
Date Issued
2019-02
Date Acceptance
2019-02-01
Citation
PLoS Medicine, 2019, 16 (2)
ISSN
1549-1277
Publisher
Public Library of Science (PLoS)
Journal / Book Title
PLoS Medicine
Volume
16
Issue
2
Copyright Statement
© 2019 Subbaraman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Sponsor
Medical Research Council (MRC)
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000460128900016&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
MR/R015600/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
PATIENT-PATHWAY ANALYSIS
PULMONARY TUBERCULOSIS
HIV CARE
PRESUMPTIVE TUBERCULOSIS
TREATMENT INITIATION
XPERT MTB/RIF
RISK-FACTORS
TB PATIENTS
DIAGNOSIS
IMPACT
Publication Status
Published
Article Number
e1002754
Date Publish Online
2019-02-27