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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Tuberculosis | Research

Impact of the COVID-19 pandemic on quality of tuberculosis care in private facilities in Bandung, Indonesia: a repeated cross-sectional standardized patients study

Authors: Angelina Sassi, Bony Wiem Lestari, Kuuni Ulfah Naila El Muna, Charity Oga-Omenka, Nur Afifah, Rodiah Widarna, Lavanya Huria, Nathaly Aguilera Vasquez, Andrea Benedetti, Panji Fortuna Hadisoemarto, Benjamin Daniels, Jishnu Das, Madhukar Pai, Bachti Alisjahbana

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

Indonesia has the second highest incidence of tuberculosis in the world. While 74% of people with tuberculosis in Indonesia first accessed the private health sector when seeking care for their symptoms, only 18% of tuberculosis notifications originate in the private sector. Little is known about the impact of the COVID-19 pandemic on the private sector. Using unannounced standardized patient visits to private providers, we aimed to measure quality of tuberculosis care during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted using standardized patients in Bandung City, West Java, Indonesia. Ten standardized patients completed 292 visits with private providers between 9 July 2021 and 21 January 2022, wherein standardized patients presented a presumptive tuberculosis case. Results were compared to standardized patients surveys conducted in the same geographical area before the onset of COVID-19.

Results

Overall, 35% (95% confidence interval (CI): 29.2–40.4%) of visits were managed correctly according to national tuberculosis guidelines. There were no significant differences in the clinical management of presumptive tuberculosis patients before and during the COVID-19 pandemic, apart from an increase in temperature checks (adjusted odds ratio (aOR): 8.05, 95% CI: 2.96–21.9, p < 0.001) and a decrease in throat examinations (aOR 0.16, 95% CI: 0.06–0.41, p = 0.002) conducted during the pandemic.

Conclusions

Results indicate that providers successfully identify tuberculosis in their patients yet do not manage them according to national guidelines. There were no major changes found in quality of tuberculosis care due to the COVID-19 pandemic. As tuberculosis notifications have declined in Indonesia due to the COVID-19 pandemic, there remains an urgent need to increase private provider engagement in Indonesia and improve quality of care.
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Metadata
Title
Impact of the COVID-19 pandemic on quality of tuberculosis care in private facilities in Bandung, Indonesia: a repeated cross-sectional standardized patients study
Authors
Angelina Sassi
Bony Wiem Lestari
Kuuni Ulfah Naila El Muna
Charity Oga-Omenka
Nur Afifah
Rodiah Widarna
Lavanya Huria
Nathaly Aguilera Vasquez
Andrea Benedetti
Panji Fortuna Hadisoemarto
Benjamin Daniels
Jishnu Das
Madhukar Pai
Bachti Alisjahbana
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-17001-y

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