期刊
TROPICAL MEDICINE AND INFECTIOUS DISEASE
卷 4, 期 4, 页码 -出版社
MDPI
DOI: 10.3390/tropicalmed4040134
关键词
active case findings; Tuberculosis; TOUCH Agent; high TB burden area; TB surveillance; 4S Screening; THALI Project; SORT IT; operational research
资金
- Department for International Development (DFID), UK
- La Fondation Veuve Emile Metz-Tesch (Luxembourg)
- United States Agency for International Development (USAID), USA
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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