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Why are inaccuratetuberculosisserological testswidely used in theIndian privatehealthcare sector? Aroot-cause analysis Szymon JarosławskiMadhukar Pai2012 год

Why are inaccurate tuberculosis serological tests widely used in the Indian private healthcare sector? A root-cause analysis
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Аннотация: Serological tests for tuberculosis are inaccurate and WHO has recommended against their use.Although not used by the Revised National TB Control Programme (RNTCP), serodiagnostics are widely used in the private sector in India.A root-cause analysis was undertaken to determine why serological tests are so popular, and seven root causes were identified that can be grouped into three categories: technical/medical, economic, and regulatory.Technical/medical: RNTCPÕs current low budget does not allow scale-up of the newer, WHO-endorsed technologies.Thus, under the RNTCP, most patients have access to only smear microscopy, a test that is insensitive and underused in the private sector.Because there is no accurate, validated, point-of-care test for TB, serological tests meet a perceived need among doctors and patients.Economic: While imported molecular or liquid culture tests are too expensive, there are no affordable Indian versions on the market, leaving serological tests as the main alternative.Although serological tests are inaccurate, various players along the value chain profit from their use, and this sustains a market for these tests.Regulatory: TB tests are poorly regulated and a large number of serological kits are on the market.Private healthcare in general is poorly regulated, and doctors in the private sector are outside the scope of RNTCP and do not necessarily follow standard guidelines.A clear understanding of these realities should facilitate market-based strategies that can help replace serological tests with accurate, validated tools.
Год издания: 2012
Авторы: Szymon Jarosławski, Madhukar Pai
Издательство: Elsevier BV
Источник: Journal of Epidemiology and Global Health
Ключевые слова: Tuberculosis Research and Epidemiology, Pneumonia and Respiratory Infections, Vaccine Coverage and Hesitancy
Другие ссылки: Journal of Epidemiology and Global Health (PDF)
Journal of Epidemiology and Global Health (HTML)
DOAJ (DOAJ: Directory of Open Access Journals) (HTML)
Europe PMC (PubMed Central) (PDF)
Europe PMC (PubMed Central) (HTML)
eScholarship@McGill (McGill) (PDF)
eScholarship@McGill (McGill) (HTML)
PubMed Central (HTML)
PubMed (HTML)