Impact of Mobile Teams on Tuberculosis Treatment Outcomes, Ministry of Health, Riyadh Region, Kingdom of Saudi Arabia, 2013 - 2015 Pubblico

Abstract

OBJECTIVE: Evaluate the impact of the Tuberculosis (TB) Mobile Teams on treatment outcomes in Riyadh region by comparing patients who received treatment under mobile teams and those who did not, from 2013 to 2015. These findings will provide information to the National TB Control Program (NTCP) on whether or not expansion of mobile teams to cover the whole country will help TB prevention and control towards its elimination.

METHODS: This is a retrospective, descriptive study using NTCP data from 2013- 2015 from Riyadh, Saudi Arabia. Descriptive analyses were used to summarize characteristics of TB case-patients served by mobile teams and those not. The chi-square test measured the significant differences between mobile served case-patients and those not. Exposure was whether or not the TB case-patient was under the care of the mobile team; the outcome of interest was whether or not treatment was successful, defined as "treatment completed" and "cured".

RESULTS: The ratio of treatment success among mobile team case-patients was 1.28 greater than among those not served by mobile teams. Chi-square test showed a statistical significant finding (Probability Ratio= 1.28;95% CI= 1.21,1.35, P-value= <0.01). Mobile teams increased the treatment success rate to 92%, compared to 71.77% among those not served by mobile teams. TB mobile teams reduced the mortality rate to 1.18% among case-patients, compared to 9.31% among those not served by mobile teams. Failure of treatment rates reached 17.19% those not served by mobile teams but only 0.86% among mobile team case-patients. Lost to follow-up rates reduced to 1.93% in mobile team patients, in comparison to 9.61% among non-mobile teams patients.

CONCLUSION: This study provides important information on the efficacy of using mobile teams to improve TB outcomes in Riyadh region, Saudi Arabia to achieve greater program outcomes. Data showed that community mobilization of mobile teams is an effective strategy to enhance TB treatment, reduced mortality and lost-to-follow-up and improve TB treatment outcomes. We recommend implementing a full-scale rollout of TB mobile team system all over the KSA, along with ongoing monitoring and evaluation of the mobile team's effectiveness by the NTCP.

Table of Contents

Table of Contents

Chapter 1: Introduction.. 1

Chapter 2: Literature Review... 4

Tuberculosis (TB) 4

TB Symptoms. 5

TB Infection Risk Factors. 5

TB Treatment. 6

Directly Observed Therapy - Short Course (DOTs): 7

Global Burden of TB. 8

TB in the Middle East. 8

Kingdom of Saudi Arabia (KSA) 9

TB in KSA. 10

National TB Control Program (NTCP) 10

TB Mobile Teams . 13

Chapter 3: Manuscript. 15

Introduction. 15

Methods. 18

Data source. 18

Study design. 18

Study variables. 18

Ethics. 19

Statistical analyses. 19

Results. 20

Discussion . 26

Chapter 4: Conclusion and Recommendations. 29

References. 30

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	Mobile teams Tuberculosis Treatment success Saudi Arabia
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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