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Retrospective Q uarterly C ohort M onitoring for patients with V isceral L eishmaniasis in the I ndian subcontinent: outcomes of a pilot project
Author(s) -
Ostyn Bart,
Malaviya Paritosh,
Hasker Epco,
Uranw Surendra,
Singh Rudra P.,
Rijal Suman,
Sundar Shyam,
Dujardin JeanClaude,
Boelaert Marleen
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12092
Subject(s) - medicine , visceral leishmaniasis , cohort , retrospective cohort study , tuberculosis , medical record , emergency medicine , pediatrics , leishmaniasis , immunology , pathology
Objective To evaluate a new tool for the monitoring of Visceral Leishmaniasis ( VL ) treatment outcomes in primary healthcare (PHC) settings, adapted from the standardised R etrospective Q uarterly C ohort M onitoring done in tuberculosis control. Methods We developed standard case definitions for early and late VL treatment outcomes, a single register allowing for one‐line entry per patient as registration tool, and quarterly reporting formats for the clinical outcomes. We pilot‐tested these tools in three I ndian P rimary H ealth C entres and two N epalese district hospitals, as well as in a charity VL treatment centre and a university hospital. Results Data collection for early treatment outcome was easily implemented but information on late treatment outcome was hard to obtain. Effectiveness of Miltefosine under routine care conditions was about 87% at end of treatment, and 76% at 6 months post‐treatment related to the high number of patients lost to follow up at the latter end point. Conclusion A retrospective cohort monitoring methodology is conceptually a good framework for monitoring clinical outcomes for chronic conditions as VL . The monitoring of early outcomes of VL treatment is perfectly feasible in P rimary C are settings. The completeness of information on late outcomes can be improved by a number of strategies that remain to be field tested. Generally, clinical outcome monitoring should be strengthened in the VL control programmes.