Screening difficult-to-reach populations for tuberculosis using a mobile medical unit, Punjab India

Binepal, G.; Agarwal, Preeti Pansari; Kaur, Navjot; Singh, Bhavana; Bhagat, Vijay Manohar; Verma, Richa; Satyanarayana, Srinath; Oeltmann, John E.; Moonan, Patrick K.

doi:10.5588/pha.15.0042

Cited by 12 publications

(14 citation statements)

References 13 publications

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“…27 Socioeconomic status and education had no significant effect on developing GDM which is in line with other studies finding no independent association between GDM, education and socioeconomic status. 16 41 A higher proportion of pregnant women in our study were anaemic (83%). The rates of anaemia were disproportionately higher compared with state averages (45.7%) and as reported in a local study (72%) conducted in a rural block of Dibrugarh district of Assam state.…”

Section: Discussionmentioning

confidence: 54%

“…14 15 Evidence also suggests that MMUs are useful in screening of diseases like tuberculosis, breast cancer, HIV, hepatitis. [16][17][18] Hence, we take the opportunity to leverage the MMU platform to reach and screen eligible pregnant women in rural Assam. We aim to determine the prevalence and associated risk factors of GDM in rural Assam.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

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Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

et al. 2020

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ObjectiveTo determine the prevalence and predictors of gestational diabetes mellitus (GDM) in rural Assam, India using a network of Mobile Medical Units.Study designA field-based cross-sectional study.SettingsRural areas of Assam state, India.ParticipantsA total of 1410 pregnant women in gestational age of 24–28 weeksInterventionIdentification of pregnant women in 24–28 weeks of pregnancy from villages and administering them Government of India recommended oral glucose tolerance test for GDM confirmation.Primary and secondary outcome measuresPresence of gestational diabetes among pregnant women, risk factors and predictors of GDM.ResultsA total of 1212 pregnant women underwent the oral glucose tolerance test. One hundred and ninety-eight women were ineligible due to existing chronic diseases or very high blood glucose level before the test. The overall GDM prevalence in Assam was 16.67% (95% CI 14.61% to 18.89%). Women aged 26–30 years (adjusted odds ratio, aOR 1.70; CI 1.14 to 2.52), who passed 10th class (aOR 1.58; CI 1.05 to 2.37), belonging to Muslim religion (aOR 1.52; 95% CI 1.05 to 2.21) and above poverty line (aOR 1.38; 95% CI 1.00 to 1.91) had significantly increased likelihood of developing GDM compared with respective baseline groups (p<0.05). Body mass index, gravida and being non-anaemic were non-significant risk factors for GDM. Family history of diabetes (aOR 1.82; 95% CI 1.08 to 3.06) and smoking (aOR 1.61; 95% CI 1.10 to 2.35) were significant and independent predictors of GDM.ConclusionThe prevalence of GDM in rural Assam is high. The mobile medical units may play a significant role in the implementation of GDM screening, diagnosis, treatment to ensure better maternal and foetal health outcomes in rural Assam.

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Section: Discussionmentioning

confidence: 54%

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

et al. 2020

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“…Prevalence of PPTB reported by other studies varied across populations, a study from India reported the prevalence to be 8%, while two others from Ghana and Cameroon reported a prevalence of 1% and 55% respectively. [6][7][8] The difference in the study setting and the operational definition of presumptive TB used in the studies may have contributed to the difference in prevalence. We used 'cough of any duration' as one of the criteria which may partially explain the higher proportion of PPTB in our study.…”

Section: Discussionmentioning

confidence: 99%

Presumptive pulmonary tuberculosis and its associated factors among adult patients availing out-patient services in a tertiary care center, Puducherry, South India

Vijayageetha

Sen

Subramanian

et al. 2020

Int J Community Med Public Health

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Background: In line with WHO’s END TB strategy and Sustainable Development Goal’s vision, India has set a goal to eliminate tuberculosis by 2025. To meet this goal, intensified case finding is a strategy adopted by India’s national tuberculosis program. This study aimed to determine the proportion of presumptive pulmonary tuberculosis (PPTB) patients among outpatients of a tertiary care center and its association with socio-demographic and behavioral factors.Methods: A hospital based cross-sectional analytical study was done in a tertiary care center during November 2017 among outpatients aged 18 years or above. Known cases of tuberculosis (TB) were excluded. Information on socio-demographic characteristics and TB symptoms was collected using a structured questionnaire. A person with any symptom suggestive of TB, including, cough of any duration, subjective weight loss, and fever at present was considered to have PPTB. Presence of PPTB was reported as proportion with 95% confidence intervals. Association between variables and presumptive pulmonary TB was assessed using chi square test and prevalence ratio with 95% CI.Results: Among 2638 outpatients, 907 (34%) had PPTB. Cough was the most reported symptom (22.9%); followed by fever (10.0%), weight loss (13.9%) and hemoptysis (0.9%). PPTB was found to be significantly higher among males, smokers, alcohol users and patients having a history of contact with any TB patient.Conclusions: One-third of the outpatients had PPTB and this was high. A screening procedure could be incorporated within the hospital policy to identify outpatients with symptoms of TB.

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“…Prospective study on inclusion of the family member as a DOT provider for paediatric patients in state of GujaratYes [29]18. Intensified Case Finding from the Community Level in 10 identified low case detection districts, Odisha, April–September 2012 – a Descriptive StudyYes [46]19.Contribution of Mobile Medical Unit for identifying TB suspects and cases in Mohali District, PunjabYes [56]20. Intensified TB case finding at Nutritional Rehabilitation Centres of Bihar, IndiaYes [50]21.…”

Section: Implementation Of Operational Research Training Coursesmentioning

confidence: 99%

“…These included: the status of screening household contacts of sputum smear positive pulmonary TB patients [48,49] and malnourished children attending nutritional rehabilitation centers [50], delays in the initiation of TB treatment after diagnosis [51], whether all TB patients diagnosed in the hospitals attached to medical college were being referred and initiated on treatment under RNTCP [52], reasons for poor uptake of HIV counselling and testing [53], status of notification of TB cases by private health care providers [54], TB treatment outcomes of MDR-TB patients [55], detection of TB cases by mobile medical units [56], innovatively addressing the challenges of routine servicing of binocular microscopes [23] and compliance to infection control practices at health facilities [57]. One study assessed innovative ways of improving programme processes such as use of photo-voice for enhancing patient adherence to therapy [58].…”

Section: Contribution Of or To Policy And Practicementioning

confidence: 99%

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

Sagili¹,

Satyanarayana

Chadha³

et al. 2018

Global Health Action

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Background: The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. Objectives: To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. Methods: From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project’s core activities and outcomes. Results: In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. Conclusions: OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.

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Screening difficult-to-reach populations for tuberculosis using a mobile medical unit, Punjab India

Cited by 12 publications

References 13 publications

Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

Prevalence and predictors of gestational diabetes mellitus in rural Assam: a cross-sectional study using mobile medical units

Presumptive pulmonary tuberculosis and its associated factors among adult patients availing out-patient services in a tertiary care center, Puducherry, South India

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

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