Community based interventions for the prevention and control of tuberculosis

Arshad, Ahmed; Salam, Rehana A; Lassi, Zohra S; Naqvi, Imama; Bhutta, Zulfiqar Ahmed

doi:10.1186/2049-9957-3-27

Cited by 42 publications

(47 citation statements)

References 38 publications

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“…Other studies from Cambodia and India reported the effectiveness and the role of Active Case Finding (ACF) in increasing case detection rates [13, 14]. A systematic review of the effectiveness of community based interventions showed a significant increase in TB case detection rates [15]. Thus, the findings from this study are in contrast to previous studies.…”

Section: Discussioncontrasting

confidence: 87%

The contribution of a non-governmental organisation’s Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time

et al. 2017

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BackgroundIt is estimated that the standard, passive case finding (PCF) strategy for detecting cases of tuberculosis (TB) in Myanmar has not been successful: 26% of cases are missing. Therefore, alternative strategies, such as active case finding (ACF) by community volunteers, have been initiated since 2011. This study aimed to assess the contribution of a Community Based TB Care Programme (CBTC) by local non-government organizations (NGOs) to TB case finding in Myanmar over 4 years.MethodsThis was a descriptive study using routine, monitoring data. Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database. Data from all 84 project townships in five regions and three states in Myanmar were used. The project was launched in 2011.ResultsOver time, the number of presumptive TB cases that were referred decreased, except in the Yangon Region, although in some areas, the numbers fluctuated. At the same time, there was a trend for the proportion of cases treated, compared to those referred, that decreased over time (P = 0.051). Overall, among 84 townships, the contribution of CBTC to total case detection deceased from 6% to 4% over time (P < 0.001).ConclusionsContrary to expectations and evidence from previous studies in other countries, a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years. This suggests that measures to support the volunteer network and improve its performance are needed. They may include discussion with local NGOs human resources personnel, incentives for the volunteers, closer supervision of volunteers and improved monitoring and evaluation tools.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0253-y) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 87%

The contribution of a non-governmental organisation’s Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time

et al. 2017

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“…5 Community-based detection and treatment of uncomplicated SAM in combination with facility-based treatment can have a major impact on mortality, 19 and TB can be integrated into existing community-based programs. 20,21 Risk assessment for TB has recently been added to community health worker manuals by the WHO and the United Nations Children's Fund, including those for integrated community case management, and is recommended for roll-out in high TB and HIV burden settings. 22 Global-level recommendations exist; for example, guidelines recently published by Action Against Hunger recommending the integration of TB and undernutrition services, the screening of children with severe malnutrition for underlying causes of acute malnutrition and referrals for further evaluation if TB and/or HIV are suspected.…”

Section: Discussionmentioning

confidence: 99%

Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries

Patel

Detjen

2017

public health action

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T uberculosis (TB) is a major public health challenge, now surpassing human immunodeficiency virus (HIV) infection as a leading cause of death from infectious disease globally. With one million estimated cases, children aged <15 years accounted for approximately 10% of the 10.4 million incident TB cases in 2015, and 210 000 children died. 1 However, only 39% of child TB cases were reported, highlighting significant underdiagnosis and under-reporting of childhood TB. 1 Despite increased awareness within the TB community and the launch of a Roadmap for Childhood Tuberculosis in 2013, 2 there is a significant policy-practice gap in implementing guidelines, capacity building at the country level, and decentralization and integration of TB services into broader child health programs to better reach children where they access the health care system. 3 This means targeting programs and services at the community and primary health care level, and health care providers caring for those at high risk for TB. It also means actively engaging key stakeholders in child health and survival, including the nutrition sector. 4,5 TUBERCULOSIS AND MALNUTRITIONApproximately 45% of deaths in children aged <5 years are attributable to undernutrition, 6 which may be acute or chronic, and categorized as moderate or severe. Children with undernutrition are at increased risk of death from infectious diseases and, conversely, severe infectious diseases in early childhood can affect nutritional status. 6 Undernutrition increases the risk of TB and TB can cause or worsen undernutrition. 7 One study estimated that 26% of overall TB cases in 22 high-burden countries are attributable to undernutrition. 8 Data on TB prevalence among acutely malnourished children vary widely: 2-24% of acutely malnourished children in high TB burden settings have been diagnosed with TB. 9-13 The wide range observed between studies can be partly attributed to the use of varying screening strategies and access to TB diagnostics, as well as varying clinical capacity for childhood TB diagnosis and treatment among hospitalized children. Even at referral hospitals, access to diagnostic tests may be limited, 14 highlighting the need for improved access to services across all levels of the health care system, including appropriate referral pathways. These data also highlight the role of TB as a comorbidity among children with acute malnutrition, emphasizing the need to routinely screen for TB and manage those at risk of TB appropriately. Asking about contacts with persons with TB is included as part of the initial history for children with severe malnutrition, as outlined in the 1999 World Health Organization (WHO) manual on the management of severe malnutrition. 15 In the WHO 2013 update on the management of severe acute malnutrition (SAM), TB screening is mentioned in the context of HIV infection. 16 We performed a review of the guidelines on acute malnutrition from high TB burden countries to identify whether and how TB is integrated within nutrition guidelines. METHODS...

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“…A community intervention is alsoessential for educating people in the population such community leaders, public figures, religious leaders and non-government organizations. This is important because those figures are considered role models who have power to influence, educate and reduce the stigma towards TBin the community (World Health Organization, 2008;Arshad et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

The Association Between Perceived Stigma Towards Tuberculosis and the Implementation of Diagnosis Procedure on Tuberculosis Screening Program in Denpasar, Bali, Indonesia

Putra

Astuti

Duana

et al. 2017

International Conference on Public Health

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Abstract:The major issue of Tuberculosis (TB) control program in Indonesia including Bali is the low cases detection rate (32%). An intensive presumptive TB finding through screening program and then followed by diagnosis procedure is important to conduct. Meanwhile, perceived stigma is a social determinant of health that strongly associated to health-seeking behaviour. This study aimed to assess the association of perceived stigma towards TB to diagnosis procedure implementation among presumptive TB casesscreened from diabetes mellitus (DM) patients. This was an operational research during the TB screening program among DM patients. The samples were collected consecutively from January until March 2016 at 11 public health centres (PHC) in Denpasar City, Bali Province. Data were collected via interview using structured questionnaire. Logistic regression was used for statistical testing. During 3 months implementation of screening program, there were 567 DM patients screened, 342 of them were presumptive TB cases and were recommended to follow TB diagnosis procedures. There were only 87(25,4%) who followed the procedure and 255 (74,6%) refused to participate. The refusal to diagnosis procedure was associated to the TB stigma (OR=1.7; 95%CI: 1.03-2.9). Meanwhile, perceivedstigma towards TB wasassociated to the lack knowledge of TB (OR=2.0; 95%CI: 1.3-3.2) and the lack of family support (OR=1.8; 95%CI: 1.1-2.7). The diagnosis procedure coverage among presumptive TB cases screened from DM patient was still low. The perceived stigma towards TB is contributed to the high proportion of presumptive TB cases who did not follow thediagnosis procedure. Therefore, a comprehensive education toincrease public awareness and supportto the TB program are necessary.

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Community based interventions for the prevention and control of tuberculosis

Cited by 42 publications

References 38 publications

The contribution of a non-governmental organisation’s Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time

The contribution of a non-governmental organisation’s Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time

Integration of childhood TB into guidelines for the management of acute malnutrition in high burden countries

The Association Between Perceived Stigma Towards Tuberculosis and the Implementation of Diagnosis Procedure on Tuberculosis Screening Program in Denpasar, Bali, Indonesia

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