Evaluation of a tuberculosis active case finding project in peri-urban areas, Myanmar: 2014-2016

Aye, Sandar; Majumdar, S. S.; Oo, Myo Minn; Tripathy, Jaya Prasad; Satyanarayana, Srinath; Kyaw, Nang Thu Thu; Kyaw, Khine Wut Yee; Oo, Nay Lynn; Thein, Soe; Thu, Myat; Soe, Kyaw; Aung, Si Thu

doi:10.1016/j.ijid.2018.02.012

Cited by 23 publications

(24 citation statements)

References 14 publications

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“…We further discuss our study findings in detail. First, the study had a low rate of PTBP detection, whereas the previous studies on ACF have consistently shown high rates of PTBP detection [23][24][25]. The TAs failed to individually enquire about symptoms that are suggestive of TB from all those who were enumerated.…”

Section: Discussionmentioning

confidence: 89%

Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed Methods Study on Outcomes and Implementation Challenges

Dey,

Thekkur,

Ghosh

et al. 2019

TropicalMed

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Active case finding (ACF) for tuberculosis (TB) was implemented in 60 selected high TB burden wards of Kolkata, India. Community volunteers called TOUCH (Targeted Outreach for Upliftment of Community Health) agents (TAs) identified and referred presumptive TB patients (PTBPs) to health facilities for TB diagnosis and treatment. We aimed to describe the “care cascade” of PTBPs that were identified during July to December 2018 and to explore the reasons for attrition as perceived by TAs and PTBPs. An explanatory mixed-methods study with a quantitative phase of cohort study using routinely collected data followed by descriptive qualitative study with in-depth interviews was conducted. Of the 3,86242 individuals that were enumerated, 1132 (0.3%) PTBPs were identified. Only 713 (63.0%) PTBPs visited a referred facility for TB diagnosis. TB was diagnosed in 177 (24.8%). The number needed to screen for one TB patient was 2183 individuals. The potential reasons for low yield were stigma and apprehension about TB, distrust about TA, wage losses for attending health facilities, and substance abuse among PTBPs. The yield of ACF was suboptimal with low PTBP identification rate and a high attrition rate. Interviewing each individual for symptoms of TB and supporting PTBPs for diagnosis through sputum collection and transport can be adopted to improve the yield.

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Section: Discussionmentioning

confidence: 89%

Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed Methods Study on Outcomes and Implementation Challenges

Dey,

Thekkur,

Ghosh

et al. 2019

TropicalMed

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“…whereas the previous studies on ACF have consistently shown high rates of PTBP detection [23][24][25].…”

Section: Discussionmentioning

confidence: 65%

Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed-methods Study on Outcomes and Implementation Challenges

Dey¹,

Thekkur²,

Ghosh³

et al. 2019

Preprint

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Background: Active case finding for TB was implemented in selected sixty high TB burden wards of Kolkata, India. Community volunteers called TOUCH agents (TAs) identified and referred presumptive TB patients (PTBPs) to health facilities for TB diagnosis and treatment. We aimed to describe the ‘care cascade’ of PTBPs identified during July to December, 2018 and to explore the reasons for attrition as perceived by TAs and PTBPs. Methods: An explanatory mixed methods study with quantitative phase of cohort study using routinely collected data followed by descriptive qualitative study with in-depth interviews was conducted. Results: Of the 3, 86,242 individuals enumerated, 1132 (0.3%) PTBPs were identified. Only 713 (63.0%) PTBPs visited referred facility for TB diagnosis. TB was diagnosed in 177 (24.8%) and the number needed to screen for one TB was 2,183 individuals. The potential reasons for low yield were stigma and apprehension about TB, distrust about TA, wage loss for attending health facilities and substance abuse among PTBPs. Conclusion: The yield of ACF was suboptimal with low PTBP identification rate and high attrition rate. Interviewing each individual for symptoms of TB and supporting PTBPs for diagnosis through sputum collection and transport can be adopted to improve the yield.

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“…The effectiveness of community-driven interventions to improve TB diagnosis and care has also been demonstrated. In Myanmar, community intervention was shown to increase case notification rates compared to household and neighborhood interventions [24]. The involvement of community volunteers in TB control was also found to increase the yield of diagnosis by 12% and reduce diagnostic delay in India and Nepal, respectively [25–27].…”

Section: Discussionmentioning

confidence: 99%

Acceptability of active case finding with a seed-and-recruit model to improve tuberculosis case detection and linkage to treatment in Cambodia: a qualitative study

Tuot

Teo

Cazabon

et al. 2019

Preprint

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2728 Background 29 With support of the national tuberculosis (TB) program, KHANA has implemented an innovative 30 approach using a seed-and-recruit model to actively find TB cases in the community. The 31 intervention engaged community members including TB survivors to recruit people with TB 32 symptoms in a 'snowball' approach for screening and linkage to treatment. This study aims to 33 explore the acceptability of active case finding with the seed-and-recruit model in detecting new 34 TB cases and determine the characteristics of successful seeds. 36 Methods37 This qualitative study was conducted in four provinces (Banteay Meanchey, Kampong Chhnang, 38 Siem Reap, and Takeo) in Cambodia in 2017. Fifty six in-depth interviews and ten focus group 39 discussions were conducted to gain insights into the acceptability, strengths, and challenges in 40 implementing the model. Transcripts were coded and content analyses were performed. 42 Results 43The seed-and-recruit active case finding model was generally well-received by the study 44 participants. They saw the benefits of engaging TB survivors and utilize their social network to 45 find new TB cases in the community. The social embeddedness of the model within the local 46 community was one of the major strengths. The success of the model also hinges on the 47 integration with existing health facilities. Having extensive social network, being motivated, and 48 having good knowledge about TB were important characteristics of successful seeds. Study 49 participants reported challenges in motivating the recruits for screening, logistic capacities, and 50 high workload during implementation. However, there was a general consensus that the model 51 ought to be expanded. 52 53 Conclusions 54 These findings indicate that the seed-and-recruit model should be fine-tuned and scaled up as 55 part of the national TB Program to increase TB new case detection in Cambodia. Further studies 3 56 are needed to more comprehensively evaluate the impacts and cost-effectiveness of the model 57 in Cambodia as well as in other resource-limited settings. 58 59 60 61 Introduction62 Cambodia is one of the 30 countries with a high burden of tuberculosis (TB) [1]. In 2016, the 63 national incidence and prevalence rates of all forms of TB were 345/100,000 population and 64 668/100,000 population, respectively [2]. These rates have reduced substantially since 1990, and 65 a similar decline was observed in the TB mortality rate [2,3]. Cambodia has made notable 66 progress in the fight against TB by achieving a treatment success rate of 94%, one of the highest 67 among the 30 high TB burden countries [4]. However, the successes are impeded by a significant 68 proportion of under-diagnosed cases. Globally, it is estimated that 36% of TB cases were 69 undiagnosed in 2017, and a similar proportion is observed in Cambodia [5][6][7]. 70In Cambodia, TB disproportionately affects people living with HIV, household and close 71 contacts of bacteriologically confirmed cases, elderly above the age of 55, ...

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Evaluation of a tuberculosis active case finding project in peri-urban areas, Myanmar: 2014-2016

Cited by 23 publications

References 14 publications

Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed Methods Study on Outcomes and Implementation Challenges

Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed Methods Study on Outcomes and Implementation Challenges

Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed-methods Study on Outcomes and Implementation Challenges

Acceptability of active case finding with a seed-and-recruit model to improve tuberculosis case detection and linkage to treatment in Cambodia: a qualitative study

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