Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes
Background: Community-based active case finding (ACF) for tuberculosis (TB) implemented among marginalised and vulnerable populations in 285 districts of India resulted in reduction of diagnosis delay and prevalence of catastrophic costs due to TB diagnosis. We were interested to know whether this t...
Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Taylor & Francis Group
2019-01-01
|
Series: | Global Health Action |
Subjects: | |
Online Access: | http://dx.doi.org/10.1080/16549716.2019.1656451 |
id |
doaj-82e55b99921a48fcae253f7c2845a937 |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hemant Deepak Shewade Vivek Gupta Srinath Satyanarayana Sunil Kumar Prabhat Pandey U. N. Bajpai Jaya Prasad Tripathy Soundappan Kathirvel Sripriya Pandurangan Subrat Mohanty Vaibhav Haribhau Ghule Karuna D. Sagili Banuru Muralidhara Prasad Priyanka Singh Kamlesh Singh Gurukartick Jayaraman P. Rajeswaran Moumita Biswas Gayadhar Mallick Ali Jafar Naqvi Ashwin Kumar Bharadwaj K. Sathiyanarayanan Aniruddha Pathak Nisha Mohan Raghuram Rao Ajay M. V. Kumar Sarabjit Singh Chadha |
spellingShingle |
Hemant Deepak Shewade Vivek Gupta Srinath Satyanarayana Sunil Kumar Prabhat Pandey U. N. Bajpai Jaya Prasad Tripathy Soundappan Kathirvel Sripriya Pandurangan Subrat Mohanty Vaibhav Haribhau Ghule Karuna D. Sagili Banuru Muralidhara Prasad Priyanka Singh Kamlesh Singh Gurukartick Jayaraman P. Rajeswaran Moumita Biswas Gayadhar Mallick Ali Jafar Naqvi Ashwin Kumar Bharadwaj K. Sathiyanarayanan Aniruddha Pathak Nisha Mohan Raghuram Rao Ajay M. V. Kumar Sarabjit Singh Chadha Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes Global Health Action tuberculosis/therapy systematic screening vulnerable populations treatment outcome community-based active case finding |
author_facet |
Hemant Deepak Shewade Vivek Gupta Srinath Satyanarayana Sunil Kumar Prabhat Pandey U. N. Bajpai Jaya Prasad Tripathy Soundappan Kathirvel Sripriya Pandurangan Subrat Mohanty Vaibhav Haribhau Ghule Karuna D. Sagili Banuru Muralidhara Prasad Priyanka Singh Kamlesh Singh Gurukartick Jayaraman P. Rajeswaran Moumita Biswas Gayadhar Mallick Ali Jafar Naqvi Ashwin Kumar Bharadwaj K. Sathiyanarayanan Aniruddha Pathak Nisha Mohan Raghuram Rao Ajay M. V. Kumar Sarabjit Singh Chadha |
author_sort |
Hemant Deepak Shewade |
title |
Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes |
title_short |
Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes |
title_full |
Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes |
title_fullStr |
Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes |
title_full_unstemmed |
Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes |
title_sort |
active versus passive case finding for tuberculosis in marginalised and vulnerable populations in india: comparison of treatment outcomes |
publisher |
Taylor & Francis Group |
series |
Global Health Action |
issn |
1654-9880 |
publishDate |
2019-01-01 |
description |
Background: Community-based active case finding (ACF) for tuberculosis (TB) implemented among marginalised and vulnerable populations in 285 districts of India resulted in reduction of diagnosis delay and prevalence of catastrophic costs due to TB diagnosis. We were interested to know whether this translated into improved treatment outcomes. Globally, there is limited published literature from marginalised and vulnerable populations on the independent effect of community-based ACF on treatment outcomes when compared to passive case finding (PCF). Objectives: To determine the relative differences in unfavourable treatment outcomes (death, loss-to-follow-up, failure, not evaluated) of ACF and PCF-diagnosed people. Methods: Cohort study involving record reviews and interviews in 18 randomly selected districts. We enrolled all ACF-diagnosed people with new smear-positive pulmonary TB, registered under the national TB programme between March 2016 and February 2017, and an equal number of randomly selected PCF-diagnosed people in the same settings. We used log binomial models to adjust for confounders. Results: Of 572 enrolled, 275 belonged to the ACF and 297 to the PCF group. The proportion of unfavourable outcomes were 10.2% (95% CI: 7.1%, 14.3%) in the ACF and 12.5% (95% CI: 9.2%, 16.7%) in the PCF group (p = 0.468). The association between ACF and unfavourable outcomes remained non-significant after adjusting for confounders available from records [aRR: 0.83 (95% CI: 0.56, 1.21)]. Due to patient non-availability at their residence, interviews were conducted for 465 (81.3%). In the 465 cohort too, there was no association after adjusting for confounders from records and interviews [aRR: 1.05 (95% CI: 0.62, 1.77)]. Conclusion: We did not find significant differences in the treatment outcomes. Due to the wide CIs, studies with larger sample sizes are urgently required. Studies are required to understand how to translate the benefits of ACF to improved treatment outcomes. |
topic |
tuberculosis/therapy systematic screening vulnerable populations treatment outcome community-based active case finding |
url |
http://dx.doi.org/10.1080/16549716.2019.1656451 |
work_keys_str_mv |
AT hemantdeepakshewade activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT vivekgupta activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT srinathsatyanarayana activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT sunilkumar activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT prabhatpandey activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT unbajpai activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT jayaprasadtripathy activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT soundappankathirvel activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT sripriyapandurangan activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT subratmohanty activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT vaibhavharibhaughule activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT karunadsagili activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT banurumuralidharaprasad activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT priyankasingh activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT kamleshsingh activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT gurukartickjayaraman activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT prajeswaran activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT moumitabiswas activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT gayadharmallick activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT alijafarnaqvi activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT ashwinkumarbharadwaj activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT ksathiyanarayanan activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT aniruddhapathak activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT nishamohan activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT raghuramrao activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT ajaymvkumar activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes AT sarabjitsinghchadha activeversuspassivecasefindingfortuberculosisinmarginalisedandvulnerablepopulationsinindiacomparisonoftreatmentoutcomes |
_version_ |
1724530397272866816 |
spelling |
doaj-82e55b99921a48fcae253f7c2845a9372020-11-25T03:41:19ZengTaylor & Francis GroupGlobal Health Action1654-98802019-01-0112110.1080/16549716.2019.16564511656451Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomesHemant Deepak Shewade0Vivek Gupta1Srinath Satyanarayana2Sunil Kumar3Prabhat Pandey4U. N. Bajpai5Jaya Prasad Tripathy6Soundappan Kathirvel7Sripriya Pandurangan8Subrat Mohanty9Vaibhav Haribhau Ghule10Karuna D. Sagili11Banuru Muralidhara Prasad12Priyanka Singh13Kamlesh Singh14Gurukartick Jayaraman15P. Rajeswaran16Moumita Biswas17Gayadhar Mallick18Ali Jafar Naqvi19Ashwin Kumar Bharadwaj20K. Sathiyanarayanan21Aniruddha Pathak22Nisha Mohan23Raghuram Rao24Ajay M. V. Kumar25Sarabjit Singh Chadha26International Union Against Tuberculosis and Lung Disease (The Union)All India Institute of Medical Sciences (AIIMS)International Union Against Tuberculosis and Lung Disease (The Union)State TB CellDepartment of TB and Communicable DiseasesVoluntary Health Association of India (VHAI)International Union Against Tuberculosis and Lung Disease (The Union)Department of Operational ResearchDepartment of TB and Communicable DiseasesDepartment of TB and Communicable DiseasesJoint Efforts for Elimination of TB (JEET) ProjectDepartment of TB and Communicable DiseasesDepartment of TB and Communicable DiseasesMAMTA Health Institute for Mother and ChildCatholic Health Association of India (CHAI)Resource Group for Education & Advocacy for Community Health (REACH)Resource Group for Education & Advocacy for Community Health (REACH)Department of TB and Communicable DiseasesDepartment of TB and Communicable DiseasesMAMTA Health Institute for Mother and ChildCatholic Health Association of India (CHAI)Resource Group for Education & Advocacy for Community Health (REACH)Department of TB and Communicable DiseasesKaruna TrustMinistry of Health and Family WelfareInternational Union Against Tuberculosis and Lung Disease (The Union)New DelhiBackground: Community-based active case finding (ACF) for tuberculosis (TB) implemented among marginalised and vulnerable populations in 285 districts of India resulted in reduction of diagnosis delay and prevalence of catastrophic costs due to TB diagnosis. We were interested to know whether this translated into improved treatment outcomes. Globally, there is limited published literature from marginalised and vulnerable populations on the independent effect of community-based ACF on treatment outcomes when compared to passive case finding (PCF). Objectives: To determine the relative differences in unfavourable treatment outcomes (death, loss-to-follow-up, failure, not evaluated) of ACF and PCF-diagnosed people. Methods: Cohort study involving record reviews and interviews in 18 randomly selected districts. We enrolled all ACF-diagnosed people with new smear-positive pulmonary TB, registered under the national TB programme between March 2016 and February 2017, and an equal number of randomly selected PCF-diagnosed people in the same settings. We used log binomial models to adjust for confounders. Results: Of 572 enrolled, 275 belonged to the ACF and 297 to the PCF group. The proportion of unfavourable outcomes were 10.2% (95% CI: 7.1%, 14.3%) in the ACF and 12.5% (95% CI: 9.2%, 16.7%) in the PCF group (p = 0.468). The association between ACF and unfavourable outcomes remained non-significant after adjusting for confounders available from records [aRR: 0.83 (95% CI: 0.56, 1.21)]. Due to patient non-availability at their residence, interviews were conducted for 465 (81.3%). In the 465 cohort too, there was no association after adjusting for confounders from records and interviews [aRR: 1.05 (95% CI: 0.62, 1.77)]. Conclusion: We did not find significant differences in the treatment outcomes. Due to the wide CIs, studies with larger sample sizes are urgently required. Studies are required to understand how to translate the benefits of ACF to improved treatment outcomes.http://dx.doi.org/10.1080/16549716.2019.1656451tuberculosis/therapysystematic screeningvulnerable populationstreatment outcomecommunity-based active case finding |