Compliance of St Joseph's Hospital Roma, Lesotho with the national tuberculosis programme of Lesotho, 2007 and 2008/Execution du programme national du Lesotho contre la tuberculose a l'hopital St Joseph de Roma, en 2007 et 2008

Background: In 2009 Lesotho had an estimated TB prevalence of 696 cases/100 000 population--the 4th highest in the world. This epidemic was characterised by high rates of death, treatment failure and unknown treatment outcomes. These adverse outcomes were attributable to a high rate of TB and/or HIV co-infection and weaknesses in the implementation of Lesotho's National Tuberculosis Programme (NTP). This study was conducted in St Joseph's Hospital, Roma (SJHR) to assess the implementation of the NTP. Method: Records of 993 patients entered into the SJHR TB register between 2007 and 2008 were reviewed. Patients' treatment details were extracted from the register, validated and analysed by STATA 10.0. Results: Of 993 patients registered: 88% were new patients, 37% were diagnosed on sputum smear microscopy alone, 35% were diagnosed on sputum smear microscopy with chest X-ray, whilst 25% were diagnosed on chest X-ray alone. In addition: 33% were sputum smear positive, 45% were sputum smear negative, and 22% had extra-pulmonary TB. As to treatment outcome: 26% were cured, 51% completed treatment, and 51% converted from sputum smear positive to sputum smear negative over six months, whilst 16% died. Regarding HIV, 77% of patients were tested for HIV and 59% had TB and/or HIV coinfection. Of ten NTP targets only the defaulter and treatment failure rate targets were met. Conclusion: Whilst only two out of ten NTP targets were met at SJHR in 2007-2008, improvements in TB case management were noted in 2008 which were probably due to the positive effects of audit on staff performance. Historique: En 2009 le Lesotho avait une frequence estimee de Tuberculose de 696 cas pour 100 000 habitants--la 4eme la plus elevee du monde. Cette epidemie etait caracterisee par un taux eleve de deces, l'echec des traitements et les resultats des traitements inconnus. Ces resultats negatifs etaient attribues au taux eleve de Tuberculose et/ou a une coinfection VIH, ainsi qu'a des lacunes dans la mise en reuvre du Programme national du Lesotho contre la Tuberculose (NTP). Cette etude a ete realisee a l'HopitaL St Joseph de Roma (SJHR) pour evaluer la mise en reuvre du NTP. Methode: Les dossiers des 993 patients inscrits dans le Registre de Tuberculose de l'hopital St Joseph entre 2007 et 2008 ont ete revises. Les informations sur le traitement des patients ont ete tirees du registre, validees et analysees par STATA 10.0. Resultats: sur les 993 patients enregistres: 88% etaient de nouve