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From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts

BACKGROUND: Tuberculosis (TB) notification in India by the Revised National TB Control Programme (RNTCP) provides information on TB patients registered for treatment from the programme. There is limited information about the proportion of patients treated for TB outside RNTCP and where these patient...

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Autores principales: Satyanarayana, Srinath, Nair, Sreenivas Achutan, Chadha, Sarabjit Singh, Shivashankar, Roopa, Sharma, Geetanjali, Yadav, Subhash, Mohanty, Subrat, Kamineni, Vishnuvardhan, Wilson, Nevin Charles, Harries, Anthony David, Dewan, Puneet Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166304/
https://www.ncbi.nlm.nih.gov/pubmed/21912669
http://dx.doi.org/10.1371/journal.pone.0024160
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author Satyanarayana, Srinath
Nair, Sreenivas Achutan
Chadha, Sarabjit Singh
Shivashankar, Roopa
Sharma, Geetanjali
Yadav, Subhash
Mohanty, Subrat
Kamineni, Vishnuvardhan
Wilson, Nevin Charles
Harries, Anthony David
Dewan, Puneet Kumar
author_facet Satyanarayana, Srinath
Nair, Sreenivas Achutan
Chadha, Sarabjit Singh
Shivashankar, Roopa
Sharma, Geetanjali
Yadav, Subhash
Mohanty, Subrat
Kamineni, Vishnuvardhan
Wilson, Nevin Charles
Harries, Anthony David
Dewan, Puneet Kumar
author_sort Satyanarayana, Srinath
collection PubMed
description BACKGROUND: Tuberculosis (TB) notification in India by the Revised National TB Control Programme (RNTCP) provides information on TB patients registered for treatment from the programme. There is limited information about the proportion of patients treated for TB outside RNTCP and where these patients access their treatment. OBJECTIVES: To estimate the proportion of patients accessing TB treatment outside the RNTCP and to identify their basic demographic characteristics. METHODS: A cross sectional community-based survey in 30 districts. Patients were identified through a door-to-door survey and interviewed using a semi-structured questionnaire. RESULTS: Of the estimated 75,000 households enumerated, 73,249 households (97.6%) were visited. Of the 371,174 household members, 761 TB patients were identified (∼205 cases per 100,000 populations). Data were collected from 609 (80%) TB patients of which 331 [54% (95% CI: 42–66%)] were determined to be taking treatment ‘under DOTS/RNTCP’. The remaining 278 [46% (95% CI: 34–57%)] were on treatment from ‘outside DOTS/RNTCP’ sources and hence were unlikely to be part of the TB notification system. Patients who were accessing treatment from ‘outside DOTS/RNTCP’ were more likely to be patients from rural areas [adjusted Odds Ratio (aOR) 2.5, 95% CI (1.2–5.3)] and whose TB was diagnosed in a non-government health facility (aOR 14.0, 95% CI 7.9–24.9). CONCLUSIONS: This community-based survey found that nearly half of self-reported TB patients were missed by TB notification system in these districts. The study highlights the need for 1) Reviewing and revising the scope of the TB notification system, 2) Strengthening and monitoring health care delivery systems with periodic assessment of the reach and utilisation of the RNTCP services especially among rural communities, 3) Advocacy, communication and social mobilisation activities focused at rural communities with low household incomes and 4) Inclusive involvement of all health-care providers, especially providers of poor rural communities.
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spelling pubmed-31663042011-09-12 From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts Satyanarayana, Srinath Nair, Sreenivas Achutan Chadha, Sarabjit Singh Shivashankar, Roopa Sharma, Geetanjali Yadav, Subhash Mohanty, Subrat Kamineni, Vishnuvardhan Wilson, Nevin Charles Harries, Anthony David Dewan, Puneet Kumar PLoS One Research Article BACKGROUND: Tuberculosis (TB) notification in India by the Revised National TB Control Programme (RNTCP) provides information on TB patients registered for treatment from the programme. There is limited information about the proportion of patients treated for TB outside RNTCP and where these patients access their treatment. OBJECTIVES: To estimate the proportion of patients accessing TB treatment outside the RNTCP and to identify their basic demographic characteristics. METHODS: A cross sectional community-based survey in 30 districts. Patients were identified through a door-to-door survey and interviewed using a semi-structured questionnaire. RESULTS: Of the estimated 75,000 households enumerated, 73,249 households (97.6%) were visited. Of the 371,174 household members, 761 TB patients were identified (∼205 cases per 100,000 populations). Data were collected from 609 (80%) TB patients of which 331 [54% (95% CI: 42–66%)] were determined to be taking treatment ‘under DOTS/RNTCP’. The remaining 278 [46% (95% CI: 34–57%)] were on treatment from ‘outside DOTS/RNTCP’ sources and hence were unlikely to be part of the TB notification system. Patients who were accessing treatment from ‘outside DOTS/RNTCP’ were more likely to be patients from rural areas [adjusted Odds Ratio (aOR) 2.5, 95% CI (1.2–5.3)] and whose TB was diagnosed in a non-government health facility (aOR 14.0, 95% CI 7.9–24.9). CONCLUSIONS: This community-based survey found that nearly half of self-reported TB patients were missed by TB notification system in these districts. The study highlights the need for 1) Reviewing and revising the scope of the TB notification system, 2) Strengthening and monitoring health care delivery systems with periodic assessment of the reach and utilisation of the RNTCP services especially among rural communities, 3) Advocacy, communication and social mobilisation activities focused at rural communities with low household incomes and 4) Inclusive involvement of all health-care providers, especially providers of poor rural communities. Public Library of Science 2011-09-02 /pmc/articles/PMC3166304/ /pubmed/21912669 http://dx.doi.org/10.1371/journal.pone.0024160 Text en Satyanarayana et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Satyanarayana, Srinath
Nair, Sreenivas Achutan
Chadha, Sarabjit Singh
Shivashankar, Roopa
Sharma, Geetanjali
Yadav, Subhash
Mohanty, Subrat
Kamineni, Vishnuvardhan
Wilson, Nevin Charles
Harries, Anthony David
Dewan, Puneet Kumar
From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
title From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
title_full From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
title_fullStr From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
title_full_unstemmed From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
title_short From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
title_sort from where are tuberculosis patients accessing treatment in india? results from a cross-sectional community based survey of 30 districts
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166304/
https://www.ncbi.nlm.nih.gov/pubmed/21912669
http://dx.doi.org/10.1371/journal.pone.0024160
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