Evaluating the detection of tuberculosis cases using a synthetic indicator (ISILOC). Province Matanzas

Abstract

It was developed a process of effective detection of tuberculosis cases, very necessary for tuberculosis control and elimination. We valued the results of an initial test of a synthetic indicator applying, to control and evaluate the quality of tuberculosis case detection in Matanzas. On the basis of retrospective data of the tuberculosis surveillance system in the province of Matanzas in 2007-2008 and the first semester of 2008-2009, of the intermediate variables: A= proportion of symptomatic respiratory patients detected; B= proportion of first made bacilloscopies; G= delay between the symptoms emergence and the first medical consultation (of the diagnosed patients); H= delay between the diagnosis and the beginning of the focus control. The case localization synthetic indicator (CLOSIN) was estimated= A+B (GH)/8 with marks ranging from 0 to 10 (0.9-1 outstanding; 0.7-0.89 very good; 0.4-0.69 satisfactory; 0.1-0.39 unsatisfactory; 0 deplorable). The municipalities of Ciénaga de Zapata and Jag ü ey were qualified as deplorable, while Marti and Pedro Betancourt were qualified as satisfactory in 2007. With the data collected in 2008 there was detected a satisfactory quality in Jag ü ey Grande and very good in Ciénaga de Zapata. In the first semester of 2008, there were detected one unsatisfactory municipality and three satisfactory; in 2009, 40 health areas were satisfactory, 12 maintained the condition of Outstanding in both trimesters, while 9 obtained an inferior category. Data suggest that CLOSIN is feasible and easy to compute and interpreting, and also discriminating in its applying because it integrates 4 variables as additional instrument of control-evaluation in the national context.