Tuberculosis, Vulnerability, and Access to Quality Care

Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study

“…These include identifying patients with prolonged cough, referring patients with prolonged cough for sputum-based TB testing, and ensuring that patients with positive test results initiate treatment and are reported to public health authorities. In Uganda, we showed previously that adherence to these guidelines is poor [ 5 ]; similar findings have been reported in other high burden countries [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Improving implementation of TB evaluation guidelines is therefore critical for making progress towards TB elimination.…”

Health worker perspectives on barriers to delivery of routine tuberculosis diagnostic evaluation services in Uganda: a qualitative study to guide clinic-based interventions

“…In Uganda, which is one of the 22 high TB burden countries according to the World Health Organization (WHO), we found that only 21% of patients with cough greater than 2 weeks’ duration were referred for sputum smear microscopy, 73% of patients referred completed sputum smear examination, and 71% of patients with a positive sputum examination were initiated on TB treatment [ 2 ]. Similar findings of providers not following guidelines for TB diagnosis and treatment have been reported from the public and private sector in many other high burden countries [ 3 - 9 ].…”

Particulate air pollution and susceptibility to the development of pulmonary tuberculosis disease in North Carolina: an ecological study

“…Tuberculosis persists as a major cause of morbidity and mortality throughout the world (Schachter 2004; Hopewell and Pai 2005; WHO 2012). Since air pollution is known to have adverse health effects in humans (Dockery et al 1993; Wei et al 2001; Pope et al 2002; Chen et al 2004; Downs et al 2007), and both laboratory experiments and epidemiological studies have raised the possibility that air pollution may increase risk of tuberculosis disease (Mishra et al 1999; Saito et al 2002a, 2002b; Hiramatsu et al 2005; Iwai et al 2005; Fullerton et al 2008), it is critical to examine the link between PTB and ambient air pollution in analytical epidemiologic studies that take into account all major potential confounders and use study designs more suited to testing hypotheses.…”