Clinical Audit on Detection of Tuberculosis at Primary Health Care Corporation, Qatar

Background: Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) is a highly infectious and contagious disease that usually infects the lungs and other parts of the body, such as brain, kidney, and bone Although, Tuberculosis (TB) is a treatable infection, however it can be fatal if not diagnosed and treated appropriately posing significant threat to the health of population with its associated morbidity and mortality According to World Health Organization (WHO), TB remained the most common cause of death from a single infectious pathogen in 2019. Considering the significance, TB control programs around the world emphasize on its early detection and immediate treatment to reduce the transmission of infectious cases Primary Health care providers play an essential role in detecting and diagnosing suspected TB cases, and referring them for treatment, thus helping to prevent spread of the disease Primary Health Care Corporation (PHCC) is a publicly funded primary healthcare provider in Qatar which provides healthcare services to a large part of the country's population. To address this important issue concerning public health, PHCC has developed and implemented Clinical Guidelines on Detection of TB, to enhance early detection of all TB probable and suspected cases, by providing disease specific protocol on the diagnosis, management, referral and follow up of TB patients and screening of contacts. Aim: To ensure that all TB probable and suspected cases are appropriately assessed, diagnosed, and referred in compliance with PHCC Guidelines on the detection of Tuberculosis in Primary Care, to find gaps if any and to generate an action plan for further improvement. Methodology: Data of all suspected (103) patients presenting to PHCC Health Centers during 1st Oct 2020 to 31st Mar 2021 was extracted for this audit. Retrospective case note review was conducted on the 103 records and data was collected against 4 audit specific criteria measures, which were selected based on the best practice evidence as derived from clinical guideline recommendations. The results of the audit were entered into a pre-formatted MS Excel for further analysis of the audit findings. Results: Based on the documented diagnosis in the medical records, majority of the cases, 93/103(90%) were suspected active TB infection and remaining 10/103(10%) were latent infection. Evidence of appropriate clinical assessment (active and latent TB infections) including the review of signs and symptoms and appropriate history documentation, was found in 83% (86/103) cases.