Pulmonary tuberculosis in migratory nomadic populations: the missing link in Iran's National Tuberculosis Programme

Honarvar, Behnam; Odoomi, Neda; Rezaei, Alireza; Hb, Haghighi; Karimi, Masoud; Hosseini, Alireza; Mazarei, S; Panahi, MH; Jamshidi, F; Moghadami, Mohsen; Kb, Lankarani

doi:10.5588/ijtld.13.0650

Cited by 13 publications

(12 citation statements)

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“…After screening 2943 titles and abstracts and 271 full-text articles, 73 unique articles fulfilled our eligibility criteria (figure 1). 14–86 The reasons for excluding full-text articles are provided in figure 1. What all included studies have in common is the goal of finding ‘missing’ TB cases through ACF, while the approaches vary greatly; from contact investigation to screening people in homeless shelters (table 1).…”

Section: Resultsmentioning

confidence: 99%

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

et al. 2019

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ObjectiveTo explore antecedents, components and influencing factors on active case-finding (ACF) policy development and implementation.DesignScoping review, searching MEDLINE, Web of Science, the Cochrane Database of Systematic Reviews and the World Health Organization (WHO) Library from January 1968 to January 2018. We excluded studies focusing on latent tuberculosis (TB) infection, passive case-finding, childhood TB and studies about effectiveness, yield, accuracy and impact without descriptions of how this evidence has/could influence ACF policy or implementation. We included any type of study written in English, and conducted frequency and thematic analyses.ResultsSeventy-three articles fulfilled our eligibility criteria. Most (67%) were published after 2010. The studies were conducted in all WHO regions, but primarily in Africa (22%), Europe (23%) and the Western-Pacific region (12%). Forty-one percent of the studies were classified as quantitative, followed by reviews (22%) and qualitative studies (12%). Most articles focused on ACF for tuberculosis contacts (25%) or migrants (32%). Fourteen percent of the articles described community-based screening of high-risk populations. Fifty-nine percent of studies reported influencing factors for ACF implementation; mostly linked to the health system (eg, resources) and the community/individual (eg, social determinants of health). Only two articles highlighted factors influencing ACF policy development (eg, politics). Six articles described WHO’s ACF-related recommendations as important antecedent for ACF. Key components of successful ACF implementation include health system capacity, mechanisms for integration, education and collaboration for ACF.ConclusionWe identified some main themes regarding the antecedents, components and influencing factors for ACF policy development and implementation. While we know much about facilitators and barriers for ACF policy implementation, we know less about how to strengthen those facilitators and how to overcome those barriers. A major knowledge gap remains when it comes to understanding which contextual factors influence ACF policy development. Research is required to understand, inform and improve ACF policy development and implementation.

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Section: Resultsmentioning

confidence: 99%

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

et al. 2019

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“…In addition, we did not find any evidence that brucellosis vaccination of livestock in our region is effective. The health of this population is further complicated as a result of herds imported from neighbouring provinces with undefined brucellosis infection or brucellosis vaccination status, weaknesses in quarantine systems at provincial borders [18], lack of herd insurance coverage, inadequate compensation for killed infected animals [18], the practice of mixing animals who have recently experienced an abortion with healthy animals, drought in the settling areas of nomads, and low levels of education in the nomads [19].…”

Section: Discussionmentioning

confidence: 99%

Brucellosis as a neglected disease in a neglected population: a seroepidemiological study of migratory nomads in the Fars province of Iran

et al. 2016

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This study assessed the seroprevalence of brucellosis and its risk factors in migratory nomads in the Fars province of Iran. Active brucellosis was defined as the combination of clinical symptoms, including fever, chills, night sweats, headache, low back pain, arthralgia, or myalgia, and positive laboratory testing, including either a serum agglutination test (SAT) ⩾1:80 with a 2-mercaptoethanol (2-ME) test ⩾1:40, or a SAT <1:80 combined with a positive Coombs Wright test (CWT) at a titre of at least threefold higher than SAT titre results. For the 536 participants, the female (316, 59%) to male (220, 41%) ratio was 1·4 and the participants' mean age was 32·4 ± 18·9 (range 1-96) years. Of all participants, 325 (60·6%) showed clinical symptoms; in symptomatic participants, the Rose Bengal plate test was positive in 33 (6·1%) cases, the SAT was positive in 18 (3·3%) cases, and the 2-ME test was positive in 30 (5·5%) cases. Positive SAT and 2-ME results were seen in 18 (3·3%) cases, but a negative SAT and a positive CWT were found in 36 (6·7%) cases. As a result, active brucellosis was detected in 54 cases, indicating a prevalence of 10% (95% confidence interval 8-12). In conclusion, we determined that brucellosis is a prevalent yet neglected disease in this nomadic population. Brucellosis control is not possible as long as these high-risk populations remain neglected.

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“…In Ethiopia, Pastoralists are the most affected by TB [4, 5] and they depend on livestock for their survival, migrating seasonally from place to place with their animals in search of fresh pasture and water [5, 6]. Pastoralism accounts for the livelihood of 50–100 million people in developing countries and Ethiopia has the largest pastoralist population in East Africa (7–8 million) [6].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitude and perceived stigma towards tuberculosis among pastoralists; Do they differ from sedentary communities? A comparative cross-sectional study

2017

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BackgroundEthiopia is ninth among the world high tuberculosis (TB) burden countries, pastoralists being the most affected population. However, there is no published report whether the behavior related to TB are different between pastoralist and the sedentary communities. Therefore, the main aim of this study is to assess the pastoralist community knowledge, attitude and perceived stigma towards tuberculosis and their health care seeking behavior in comparison to the neighboring sedentary communities and this may help to plan TB control interventions specifically for the pastoralist communities.MethodA community-based cross-sectional survey was carried out from September 2014 to January 2015, among 337 individuals from pastoralist and 247 from the sedentary community of Kereyu district. Data were collected using structured questionnaires. Three focus group discussions were used to collect qualitative data, one with men and the other with women in the pastoralist and one with men in the sedentary groups. Data were analyzed using Statistical Software for Social Science, SPSS V 22 and STATA.ResultsA Lower proportion of pastoralists mentioned bacilli (bacteria) as the cause of PTB compared to the sedentary group (63.9% vs. 81.0%, p<0.01), respectively. However, witchcraft was reported as the causes of TB by a higher proportion of pastoralists than the sedentary group (53.6% vs.23.5%, p<0.01), respectively. Similarly, a lower proportion of pastoralists indicated PTB is preventable compared to the sedentary group (95.8% vs. 99.6%, p<0.01), respectively. Moreover, majority of the pastoralists mentioned that most people would reject a TB patient in their community compared to the sedentary group (39.9% vs. 8.9%, p<0.001), respectively, and the pastoralists expressed that they would be ashamed/embarrassed if they had TB 68% vs.36.4%, p<0.001), respectively.ConclusionThe finding indicates that there is a lower awareness about TB, a negative attitude towards TB patients and a higher perceived stigma among pastoralists compared to their neighbor sedentary population. Strategic health communications pertinent to the pastoralists way of life should be planned and implemented to improve the awareness gap about tuberculosis.

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Pulmonary tuberculosis in migratory nomadic populations: the missing link in Iran's National Tuberculosis Programme

Cited by 13 publications

References 0 publications

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

Brucellosis as a neglected disease in a neglected population: a seroepidemiological study of migratory nomads in the Fars province of Iran

Knowledge, attitude and perceived stigma towards tuberculosis among pastoralists; Do they differ from sedentary communities? A comparative cross-sectional study

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