Factors contributing to the poor adult tuberculosis referral system in Lusaka urban, Zambia.

Abstract

The main objective of this study was to analyse the current adult tuberculosis referral system in Lusaka Urban in order to identify factors contributing to the poor quality of the system and make recommendations to relevant authorities for appropriate action. The study was conducted at the University Teaching Hospital Chest Clinic and eight health centres from the eight health centre Zones in Lusaka Urban. Data from 50 randomly selected patients currently on tuberculosis chemotherapy was collected using a semi structured interview schedule. Focus group discussions were used to collect data from chest clinic and health centre staff. A descriptive and explanatory study was undertaken. Literature reviewed was based on patient, staff and the referral system factors that would affect the effectiveness of the Tuberculosis referral System. Results from this study revealed that health workers involved in the treatment and control of tuberculosis had high theoretical knowledge on the current referral system. However, there was lack of communication between health centre and chest clinic, lack of contact tracing, follow up of referrals, and close supervision of patients' daily drug intake. There were long distances between chest clinic and patients residences, long waiting time at chest clinic, very ill patients were prescribed on ambulatory treatment and patients had Nvnimal knowledge on the cause, treatment, prevention and control of tuberculosis. Health centres also had inadequate supply of drugs used in the treatment of tuberculosis.