Table 3.
Factors associated with referral of SPs with presumptive TB or MDR-TB for medical assessment
| Predictors | Presumptive TB | Presumptive MDR-TB | ||||||
| N=318 | N=320 | |||||||
| Referred to healthcare provider (yes) Frequency (%) |
Referred to healthcare provider (no) Frequency (%) |
Unadjusted OR (95% CI) (referred compared with not referred) | aOR (95% CI) (referred compared with not referred) n=317 (model 1) | Referred to healthcare provider (yes) Frequency (%) |
Referred to healthcare provider (no) Frequency (%) |
OR (95% CI) (referred compared with not referred) | aOR (95% CI) (referred compared with not referred) n=319 (model 2) | |
| Region | ||||||||
| North | 9 (23.1) | 191 (68.5) | 1.0 | 1.0 | 46 (39.7) | 155 (76.0) | 1.0 | 1.0 |
| South | 30 (76.9) | 88 (31.5) | 7.2 (3.3 to 15.9) | 8.78 (3.8 to 20.4) | 70 (60.3) | 49 (24.0) | 4.8 (2.9 to 7.9) | 4.7 (2.9 to 7.8) |
| Geographical location | ||||||||
| Rural | 37 (94.9) | 236 (84.6) | 1.0 | NI | 95 (81.9) | 180 (88.2) | 1.0 | NP |
| Urban | 2 (5.1) | 43 (15.4) | 0.3 (0.1 to 1.3) | 21 (18.1) | 24 (11.8) | 1.7 (0.9 to 3.1) | ||
| Medical history taken by pharmacy staff | ||||||||
| No | 10 (8.1) | 113 (91.9) | 1.0 | 1.0 | 20 (17.2) | 55 (27.0) | 1.0 | 1.0 |
| Yes | 29 (14.9) | 166 (85.1) | 2.0 (0.9 to 4.2) | 3.9 (1.7 to 9.0) | 96 (82.8) | 149 (73.0) | 1.8 (1.0 to 3.1) | 1.8 (1.0 to 3.2) |
| Number of pharmacies/10 000 commune population | ||||||||
| Median (IQR) | 10.7 (5.5–16.6) | 10.7 (6.9–17.7) | 10.6 (5.9–16.1) | 10.8 (6.8–18.3) | NP | |||
| Low (<median) | 1.0 | NP | 1.0 | |||||
| High (≥median) | 0.7 (0.9 to 1.7) | 0.9 (0.6 to 1.5) | ||||||
| Gender of attending staff | ||||||||
| Female | 29 (74.4) | 216 (77.4) | 1.0 | NP | 86 (74.1) | 169 (82.8) | 1.0 | NP |
| Male | 10 (25.6) | 63 (22.6) | 1.2 (0.5 to 2.6) | 30 (25.9) | 35 (17.2) | 1.7 (1.0 to 2.9) | ||
| Registration status | NP | |||||||
| Not registered | 6 (15.4) | 123 (44.1) | 1.0 | 30 (25.9) | 98 (48.0) | 1.0 | NP | |
| Registered | 33 (84.6) | 156 (65.9) | 4.3 (1.8 to 10.7) | 86 (74.1) | 106 (52.0) | 2.6 (1.6 to 4.4) | ||
| Type of facility | NI | |||||||
| Pharmacy | 1 (2.6) | 29 (10.4) | 1.0 | 16 (13.8) | 22 (10.8) | 1.0 | NP | |
| Drug counter | 38 (97.4) | 250 (89.6) | 4.4 (0.6 to 33.3) | 100 (86.2) | 182 (89.2) | 0.8 (0.4 to 1.5) | ||
| Interaction time (min) | NP | NP | ||||||
| Median (IQR) | 4 (4–5) | 4.0 (3–5) | ||||||
| Missing values | 0 | 1 | 4.5 (4–5) | 5.0 (4–5) | ||||
| Low (<median) | 1.0 | 1.0 | ||||||
| High (≥median) | 2.5 (1.1 to 5.9) | 0.9 (0.6 to 1.5) | ||||||
| Commune population density (PPH) | NP | |||||||
| Median (IQR) | 8.4 (4.5–11.6) | 12.2 (8.0–17.1) | 10.6 (6.1–16.2) | 12.6 (8.7–17.1) | ||||
| Low (<median) | 1.0 | 1.0 | 1.0 | |||||
| High (≥median) | 0.3 (0.1 to 0.6) | 0.4 (0.2 to 0.9) | 0.6 (0.4 to 0.9) | |||||
Model accuracy and fit: model 1: PAC=87.7%, omnibus χ2 test for the model <0.001 and Hosmer and Lemeshow χ2 test for the model=0.581.
Model 2: PAC=71.2%, omnibus χ2 test for the model <0.001 and Hosmer and Lemeshow χ2 test for the model=0.840. All of these values indicate that the models fit well.
aOR, adjusted OR; CI, 95% Confidence Interval; MDR-TB, multidrug-resistant tuberculosis; NI, not included in the adjusted model due to few/no observations found in one cell or few cells; NP, not predicted in the dimension of final model produced using backward deletion method; PAC, percentage accuracy in classification; PPH, number of people per hectare; SP, standardised patient.