Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study
Background. Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB...
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doaj-7edb76a98dc844e4beadc35f54d874132020-11-25T01:26:05ZengHindawi LimitedTuberculosis Research and Treatment2090-150X2090-15182020-01-01202010.1155/2020/97463299746329Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative StudyAmrita N. Shamanewadi0Poonam R. Naik1Pruthu Thekkur2Suwarna Madhukumar3Abhay Subhashrao Nirgude4M. B. Pavithra5Basavaraj Poojar6Vivek Sharma7Arnav Prashanth Urs8B. V. Nisarga9N. Shakila10Sharath Burugina Nagaraja11Department of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, IndiaDepartment of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore Pin-575018, IndiaCentre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris Pin-75006, FranceDepartment of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, IndiaDepartment of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore Pin-575018, IndiaDepartment of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, IndiaDepartment of Pharmacology, Kasturba Medical College, Mangalore Pin-575003, IndiaMonitoring and Evaluation Division, THALI, JSI India, West Bengal Pin: 700107, IndiaDepartment of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, IndiaDepartment of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, IndiaDistrict Tuberculosis Officer, Bengaluru Rural District, Bengaluru, IndiaDepartment of Community Medicine, ESIC Medical College and PGIMSR, Bengaluru Pin-560010, IndiaBackground. Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB Program (NTP) of India has initiated ACF for TB through the existing general health system since the end of 2017. However, prior to scale-up, there is need for exploring the implementation challenges and solutions to improve the efficiency of this program. Objectives. (1) To explore the enablers and challenges in the implementation of ACF for TB by NTP in the Bengaluru rural district of Karnataka, South India, and (2) to explore the perceived solutions to improve the efficiency of ACF activity. Methods. A qualitative descriptive study was conducted in the Bengaluru rural district during July 2018. In-depth interviews using purposively selected health care providers involved in active case finding (n=9) and presumptive TB patients (n=8) were conducted. Manual content analysis was conducted by two independent researchers to generate categories and themes. Results. The challenges in conduct of ACF were as follows: inadequate training of health care workers, shortage of staff, indifferent attitude of community due to stigma, lack of awareness about TB, illiteracy, inability to convince patients for sputum test, and delay in getting CBNAAT results. The field staff recommended the installation of mobile CBNAAT machine, involvement of general health staff in activity, training of health workers on counseling of patients, and issue of identity cards for community health workers/volunteers so that people recognize them. Conclusion. The health system challenges in conduct of ACF need to be addressed by training the health staff involved in activity and also improving the access to TB diagnostics.http://dx.doi.org/10.1155/2020/9746329 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amrita N. Shamanewadi Poonam R. Naik Pruthu Thekkur Suwarna Madhukumar Abhay Subhashrao Nirgude M. B. Pavithra Basavaraj Poojar Vivek Sharma Arnav Prashanth Urs B. V. Nisarga N. Shakila Sharath Burugina Nagaraja |
spellingShingle |
Amrita N. Shamanewadi Poonam R. Naik Pruthu Thekkur Suwarna Madhukumar Abhay Subhashrao Nirgude M. B. Pavithra Basavaraj Poojar Vivek Sharma Arnav Prashanth Urs B. V. Nisarga N. Shakila Sharath Burugina Nagaraja Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study Tuberculosis Research and Treatment |
author_facet |
Amrita N. Shamanewadi Poonam R. Naik Pruthu Thekkur Suwarna Madhukumar Abhay Subhashrao Nirgude M. B. Pavithra Basavaraj Poojar Vivek Sharma Arnav Prashanth Urs B. V. Nisarga N. Shakila Sharath Burugina Nagaraja |
author_sort |
Amrita N. Shamanewadi |
title |
Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study |
title_short |
Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study |
title_full |
Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study |
title_fullStr |
Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study |
title_full_unstemmed |
Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study |
title_sort |
enablers and challenges in the implementation of active case findings in a selected district of karnataka, south india: a qualitative study |
publisher |
Hindawi Limited |
series |
Tuberculosis Research and Treatment |
issn |
2090-150X 2090-1518 |
publishDate |
2020-01-01 |
description |
Background. Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB Program (NTP) of India has initiated ACF for TB through the existing general health system since the end of 2017. However, prior to scale-up, there is need for exploring the implementation challenges and solutions to improve the efficiency of this program. Objectives. (1) To explore the enablers and challenges in the implementation of ACF for TB by NTP in the Bengaluru rural district of Karnataka, South India, and (2) to explore the perceived solutions to improve the efficiency of ACF activity. Methods. A qualitative descriptive study was conducted in the Bengaluru rural district during July 2018. In-depth interviews using purposively selected health care providers involved in active case finding (n=9) and presumptive TB patients (n=8) were conducted. Manual content analysis was conducted by two independent researchers to generate categories and themes. Results. The challenges in conduct of ACF were as follows: inadequate training of health care workers, shortage of staff, indifferent attitude of community due to stigma, lack of awareness about TB, illiteracy, inability to convince patients for sputum test, and delay in getting CBNAAT results. The field staff recommended the installation of mobile CBNAAT machine, involvement of general health staff in activity, training of health workers on counseling of patients, and issue of identity cards for community health workers/volunteers so that people recognize them. Conclusion. The health system challenges in conduct of ACF need to be addressed by training the health staff involved in activity and also improving the access to TB diagnostics. |
url |
http://dx.doi.org/10.1155/2020/9746329 |
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