Tuberculosis care cascade for the indigenous population in Colombia: an operational research study
Objective. Construct and evaluate the care cascade for pulmonary tuberculosis in the indigenous population of the department of Cauca (Colombia) and identify existing gaps. Methods. Mixed-methods sequential explanatory design. In the first phase, the pulmonary tuberculosis care cascade for the indig...
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2021-02-01
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doaj-e22db0a37e224d50ad16e989b29869862021-02-23T10:55:59ZengPan American Health OrganizationRevista Panamericana de Salud Pública1020-49891680-53482021-02-0145201910.26633/RPSP.2021.20rpspTuberculosis care cascade for the indigenous population in Colombia: an operational research studyJhon Edwin Polanco-Pasaje0Iader Rodríguez-Márquez1Kelly Yoana Tello-Hoyos2Pilar Torres-Pereda3Bertha Leonor Guzmán-Salazar4Freddy Pérez5Grupo de Investigación Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.Grupo de Investigación Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.Secretaría de Salud Departamental, Gobernación del Cauca, Colombia.Instituto Nacional de Salud Pública, Cuernavaca, Mexico.Secretaría de Salud Departamental, Gobernación del Cauca, Colombia.Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washington D.C., United States of America.Objective. Construct and evaluate the care cascade for pulmonary tuberculosis in the indigenous population of the department of Cauca (Colombia) and identify existing gaps. Methods. Mixed-methods sequential explanatory design. In the first phase, the pulmonary tuberculosis care cascade for the indigenous population of Cauca was evaluated. Data were obtained from secondary sources and all cases diagnosed from 1 January 2016 to 31 December 2017 were included. In the second phase, semi-structured interviews were done with nine program coordinators and 11 nursing auxiliaries to explain identified gaps. Absolute and percentage values were estimated for each of the steps and gaps in the care cascade. Quantitative and qualitative results were triangulated. Results. In 2016 and 2017, an estimated 202 patients with respiratory symptoms were expected to be positive and 106 cases of pulmonary tuberculosis were reported among the indigenous population of the department of Cauca. A gap of 47.5% was found for diagnosis, since only 52.5% of subjects were diagnosed in health services. This gap was explained by poor quality of samples and flawed smear techniques; flaws in correct identification of patients with respiratory symptoms; limited access to diagnostic methods, such as culture and molecular tests; and limited training and high turnover of personnel in health service provider institutions. Conclusions. The tuberculosis control program should focus actions on bridging the gap in case detection in the indigenous population.https://iris.paho.org/handle/10665.2/53281tuberculosisindigenous populationhealth services, indigenoushealth care quality, access, and evaluationcolombia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jhon Edwin Polanco-Pasaje Iader Rodríguez-Márquez Kelly Yoana Tello-Hoyos Pilar Torres-Pereda Bertha Leonor Guzmán-Salazar Freddy Pérez |
spellingShingle |
Jhon Edwin Polanco-Pasaje Iader Rodríguez-Márquez Kelly Yoana Tello-Hoyos Pilar Torres-Pereda Bertha Leonor Guzmán-Salazar Freddy Pérez Tuberculosis care cascade for the indigenous population in Colombia: an operational research study Revista Panamericana de Salud Pública tuberculosis indigenous population health services, indigenous health care quality, access, and evaluation colombia |
author_facet |
Jhon Edwin Polanco-Pasaje Iader Rodríguez-Márquez Kelly Yoana Tello-Hoyos Pilar Torres-Pereda Bertha Leonor Guzmán-Salazar Freddy Pérez |
author_sort |
Jhon Edwin Polanco-Pasaje |
title |
Tuberculosis care cascade for the indigenous population in Colombia: an operational research study |
title_short |
Tuberculosis care cascade for the indigenous population in Colombia: an operational research study |
title_full |
Tuberculosis care cascade for the indigenous population in Colombia: an operational research study |
title_fullStr |
Tuberculosis care cascade for the indigenous population in Colombia: an operational research study |
title_full_unstemmed |
Tuberculosis care cascade for the indigenous population in Colombia: an operational research study |
title_sort |
tuberculosis care cascade for the indigenous population in colombia: an operational research study |
publisher |
Pan American Health Organization |
series |
Revista Panamericana de Salud Pública |
issn |
1020-4989 1680-5348 |
publishDate |
2021-02-01 |
description |
Objective. Construct and evaluate the care cascade for pulmonary tuberculosis in the indigenous population of the department of Cauca (Colombia) and identify existing gaps.
Methods. Mixed-methods sequential explanatory design. In the first phase, the pulmonary tuberculosis care cascade for the indigenous population of Cauca was evaluated. Data were obtained from secondary sources and all cases diagnosed from 1 January 2016 to 31 December 2017 were included. In the second phase, semi-structured interviews were done with nine program coordinators and 11 nursing auxiliaries to explain identified gaps. Absolute and percentage values were estimated for each of the steps and gaps in the care cascade. Quantitative and qualitative results were triangulated.
Results. In 2016 and 2017, an estimated 202 patients with respiratory symptoms were expected to be positive and 106 cases of pulmonary tuberculosis were reported among the indigenous population of the department of Cauca. A gap of 47.5% was found for diagnosis, since only 52.5% of subjects were diagnosed in health services. This gap was explained by poor quality of samples and flawed smear techniques; flaws in correct identification of patients with respiratory symptoms; limited access to diagnostic methods, such as culture and molecular tests; and limited training and high turnover of personnel in health service provider institutions.
Conclusions. The tuberculosis control program should focus actions on bridging the gap in case detection in the indigenous population. |
topic |
tuberculosis indigenous population health services, indigenous health care quality, access, and evaluation colombia |
url |
https://iris.paho.org/handle/10665.2/53281 |
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