RESUMO
To determine the registration status of patients with tuberculosis [TB] detected by private laboratories. a cross sectional study Out of all TB suspected subjects referred to four private labs for acid-fast bacilli [AFB] examination during 2002-3, those with confirmed TB were enrolled in this study. All AFB positive cases were then followed for registration by National Tuberculosis Program [NTP] of the Ministry of Health of Iran. Of all the cases referred to the private laboratories, 646 subjects were reported as AFB positive and followed. Of these, 317 [49.1%] were female and 328 [50.8%] male, with a mean age of 52.2 years [95% CI, 21.7]. Using telephone and dwelling addresses to contact patients, 82 [12.7%] patients were found to be registered by NTP and 564 [87.3%] were not registered. Registration status was independent of age and sex [p=0.122, p=0.178]. However, a positive association was detected between physician referral of patients and registration [Fisher's exact test, p<0.00 1]. The cases detected and treated by private sector are far beyond our expectation, which indicates the valuable role of this sector in tuberculosis detection. Nevertheless, what needs to be improved is the management of relations between private and public sectors. On the other hand, physicians play an essential role in referring patients to NTP for registration, but it seems that they have not been performing well enough given the small proportion of patients referred
RESUMO
To study the role of the private sector in detection and diagnosis of tuberculosis suspected cases by referring to the private labs. This Cross sectional study was performed to evaluate all cases referring to 4 private labs for AFB examination during 2002-3. The total number of referred cases and the positivity ratio were calculated. A total of 9037 were enrolled into our study, 44.9% being female and 55.1% being male. The two peak ages of patients were 15-25 yrs and >65 yrs and the majority of the patients were Iranians [98.6%]. As a whole, 637 cases had positive examination results [7.1%], among which 531[5.9%] cases were direct smear positive and 489[5.4%] culture positive. This is comparable to data given by MOH, where the total number of cases referred to governmental labs in the Tehran urban area, during the period of study was 9479, including 7850[82.8%] Iranians and 208[2.2%] being positive. A larger than expected proportion of TB patients are detected and [managed] by the private sector which indicates that a much more intimate cooperation should develop between the public and private sectors