Coverage of Drug Susceptibility Testing among New and Previously Treated Tuberculosis Patients in Public Health Region 3, Fiscal Year 2020–2023

Abstract

Background: Drug-resistant tuberculosis (DR-TB) remains a critical public health challenge in Thailand. This descriptive study aimed to evaluate the coverage of DR-TB screening among newly diagnosed tuberculosis (TB) patients and those with a history of previous TB treatment, registered during fiscal years 2020 to 2023. Methods: Data were collected from 53 public hospitals under the Ministry of Public Health across five provinces Nakhon Sawan, Kamphaeng Phet, Phichit, Chai Nat, and Uthai Thani in Health Region 3. Information on drug susceptibility testing (DST) was obtained from the national tuberculosis database. For fiscal year 2023, DST data were compared with findings from supervisory site visits to assess accuracy and completeness. Results: In fiscal year 2020, the proportion of patients who underwent DST compared to those registered for treatment was 49.7%. In fiscal year 2023, the proportion of patients who underwent DST compared to those registered for treatment was 84.5%. In fiscal year 2020, the corresponding proportions for patients with available DST results were 38.4%. In fiscal year 2023, the corresponding proportions for patients with available DST results were 81.1%. In fiscal year 2023, categorized by patient characteristics, it was found that the drug susceptibility testing of new pulmonary tuberculosis patients in each province was between 76.3–92.3%. The corresponding proportions for patients with available DST results were between 75.6–90.9%. Categorized by patient characteristics, it was found that the drug susceptibility testing of Previously Treated Tuberculosis Patients in each province was between 83.0–96.7%. The corresponding proportions for patients with available DST results were between 74.0–91.0%. Conclusion: Although DST coverage improved substantially between 2020 and 2023, key barriers remain. The most common reasons for missed testing included a lack of awareness regarding referral criteria. Delays or absences of test results were primarily due to sputum transport issues, weak coordination between TB clinics and laboratories, and incomplete or delayed data entry into the national TB database. Strengthening training on referral guidelines and ensuring timely, integrated data reporting are essential to further enhance DR-TB surveillance and care.