Control of tuberculosis by community health workers in Bangladesh

Chowdhury, A Mushtaque R; Chowdhury, Sadia; Islam, Nazrul; Islam, Akramul; Vaughan, J. G.

doi:10.1016/s0140-6736(96)11311-8

Cited by 112 publications

(56 citation statements)

References 10 publications

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“…Our results are in keeping with other studies conducted in South Africa (Dick et al 1997), Thailand (Kamolratanakul et al 1999, Bangladesh (Chowdhury et al 1997) and China (China Tuberculosis Control Collaboration 1996). Our study was different from other randomized trials of DOT, conducted in Pakistan (Walley et al 2001) and South Africa (Zwarenstein et al 1998), in that the observer was a non-family member of the same community and there was no self-supervision.…”

Section: Discussionsupporting

confidence: 93%

Evaluation of efficacy of community‐based vs. institutional‐based direct observed short‐course treatment for the control of tuberculosis in Kilombero district, Tanzania

Lwilla

Schellenberg

Masanja

et al. 2003

Tropical Med Int Health

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SummaryTuberculosis (TB) has reappeared as a serious public health problem. Non-compliance to antituberculous drug treatment is cited as one of the major obstacles to the containment of the epidemic. Compliance may be optimized by Directly Observed Treatment (DOT) and short-course treatment regimens. Since 1986, Tanzanian TB patients have received daily DOT at health facilities for the first 2 months of the treatment course. However, adherence and cure rates have been falling as the number of TB cases continues to increase and the burden on already stretched health facilities threatens to become unmanageable. We used an open cluster randomized controlled trial to compare community-based DOT (CBDOT) using a short-course drug regimen with institutional-based DOT (IBDOT). A total of 522 (301 IBDOT and 221 CBDOT) patients with sputum-positive TB were recruited. Overall, there was no significant difference in conversion and cure rates between the two strategies [M-H pooled odds ratio (OR) 0.62; 95% confidence interval (CI) 0.23, 1.71 and OR ¼ 1.58; 95% CI 0.32, 7.88, respectively] suggesting that CBDOT may be a viable alternative to IBDOT. CBDOT may be particularly useful in parts of the country where people live far from health facilities.

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Section: Discussionsupporting

confidence: 93%

Evaluation of efficacy of community‐based vs. institutional‐based direct observed short‐course treatment for the control of tuberculosis in Kilombero district, Tanzania

Lwilla

Schellenberg

Masanja

et al. 2003

Tropical Med Int Health

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“…Chowdhury and colleagues reported that a successful TB control programme by community health workers in Bangladesh improved case-finding and treatment compliance. 29 A similar achievement was reported from the Philippines. 15 However, no data have so far been published on the effect of such interventions on pre-treatment symptom duration.…”

supporting

confidence: 78%

TB case-finding in southern Ethiopia

Shargie

Mørkve

Lindtjørn

2006

Bull World Health Organ

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Objective To ascertain whether case-finding through community outreach in a rural setting has an effect on case-notification rate, symptom duration, and treatment outcome of smear-positive tuberculosis (TB). Methods We randomly allocated 32 rural communities to intervention or control groups. In intervention communities, health workers from seven health centres held monthly diagnostic outreach clinics at which they obtained sputum samples for sputum microscopy from symptomatic TB suspects. In addition, trained community promoters distributed leaflets and discussed symptoms of TB during house visits and at popular gatherings. Symptomatic individuals were encouraged to visit the outreach team or a nearby health facility. In control communities, cases were detected through passive case-finding among symptomatic suspects reporting to health facilities. Smear-positive TB patients from the intervention and control communities diagnosed during the study period were prospectively enrolled. Findings In the 1-year study period, 159 and 221 cases of smear-positive TB were detected in the intervention and control groups, respectively. Case-notification rates in all age groups were 124.6/10 5 and 98.1/10 5 person-years, respectively (P = 0.12). The corresponding rates in adults older than 14 years were 207/10 5 and 158/10 5 person-years, respectively (P = 0.09). The proportion of patients with >3 months' symptom duration was 41% in the intervention group compared with 63% in the control group (P<0.001). Pre-treatment symptom duration in the intervention group fell by 55-60% compared with 3-20% in the control group. In the intervention and control groups, 81% and 75%, respectively of patients successfully completed treatment (P = 0.12). Conclusion The intervention was effective in improving the speed but not the extent of case finding for smear-positive TB in this setting. Both groups had comparable treatment outcomes.Keywords Tuberculosis -prevention and control; Disease notification; Tuberculosis -diagnosis; Ethiopia (source: MeSH, NLM). Mots clés Tuberculose -prévention et contrôle; Notification maladie; Tuberculose -diagnostic; Ethiopie (source: MeSH, INSERM). Palabras clave Tuberculosis -prevención y control; Notificación de enfermedad; Tuberculosis -diagnóstico; Etiopía (fuente: DeCS, BIREME). Voir page 117 le résumé en français. En la página 117 figura un resumen en español.

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“…After 2 and 8 weeks of inception of treatment regimen uric acid level was detected 5.6 ± 2.1 and 5.7 ± 2.5 mg/dL (Table III) (Chowdhury et al, 1997), on microscopic diagnosis (Vandeun and Portalels, 1998) and drug resistance surveillance (Haque et al, 1995).…”

Section: Resultsmentioning

confidence: 99%