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Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia

BACKGROUND: TB Control Programmes rely on passive case-finding to detect cases. TB notification remains low in Ethiopia despite major expansion of health services. Poor rural communities face many barriers to service access. METHODS AND FINDINGS: A community-based intervention package was implemente...

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Autores principales: Yassin, Mohammed A., Datiko, Daniel G., Tulloch, Olivia, Markos, Paulos, Aschalew, Melkamsew, Shargie, Estifanos B., Dangisso, Mesay H., Komatsu, Ryuichi, Sahu, Suvanand, Blok, Lucie, Cuevas, Luis E., Theobald, Sally
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664633/
https://www.ncbi.nlm.nih.gov/pubmed/23723975
http://dx.doi.org/10.1371/journal.pone.0063174
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author Yassin, Mohammed A.
Datiko, Daniel G.
Tulloch, Olivia
Markos, Paulos
Aschalew, Melkamsew
Shargie, Estifanos B.
Dangisso, Mesay H.
Komatsu, Ryuichi
Sahu, Suvanand
Blok, Lucie
Cuevas, Luis E.
Theobald, Sally
author_facet Yassin, Mohammed A.
Datiko, Daniel G.
Tulloch, Olivia
Markos, Paulos
Aschalew, Melkamsew
Shargie, Estifanos B.
Dangisso, Mesay H.
Komatsu, Ryuichi
Sahu, Suvanand
Blok, Lucie
Cuevas, Luis E.
Theobald, Sally
author_sort Yassin, Mohammed A.
collection PubMed
description BACKGROUND: TB Control Programmes rely on passive case-finding to detect cases. TB notification remains low in Ethiopia despite major expansion of health services. Poor rural communities face many barriers to service access. METHODS AND FINDINGS: A community-based intervention package was implemented in Sidama zone, Ethiopia. The package included advocacy, training, engaging stakeholders and communities and active case-finding by female Health Extension Workers (HEWs) at village level. HEWs conducted house-to-house visits, identified individuals with a cough for two or more weeks, with or without other symptoms, collected sputum, prepared smears and supervised treatment. Supervisors transported smears for microscopy, started treatment, screened contacts and initiated Isoniazid preventive therapy (IPT) for children. Outcomes were compared with the pre-implementation period and a control zone. Qualitative research was conducted to understand community and provider perceptions and experiences. HEWs screened 49,857 symptomatic individuals (60% women) from October 2010 to December 2011. 2,262 (4·5%) had smear-positive TB (53% women). Case notification increased from 64 to 127/100,000 population/year resulting in 5,090 PTB+ and 7,071 cases of all forms of TB. Of 8,005 contacts visited, 1,949 were symptomatic, 1,290 symptomatic were tested and 69 diagnosed with TB. 1,080 children received IPT. Treatment success for smear-positive TB increased from 77% to 93% and treatment default decreased from 11% to 3%. Service users and providers found the intervention package highly acceptable. CONCLUSIONS: Community-based interventions made TB diagnostic and treatment services more accessible to the poor, women, elderly and children, doubling the notification rate and improving treatment outcome. This approach could improve TB diagnosis and treatment in other high burden settings.
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spelling pubmed-36646332013-05-30 Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia Yassin, Mohammed A. Datiko, Daniel G. Tulloch, Olivia Markos, Paulos Aschalew, Melkamsew Shargie, Estifanos B. Dangisso, Mesay H. Komatsu, Ryuichi Sahu, Suvanand Blok, Lucie Cuevas, Luis E. Theobald, Sally PLoS One Research Article BACKGROUND: TB Control Programmes rely on passive case-finding to detect cases. TB notification remains low in Ethiopia despite major expansion of health services. Poor rural communities face many barriers to service access. METHODS AND FINDINGS: A community-based intervention package was implemented in Sidama zone, Ethiopia. The package included advocacy, training, engaging stakeholders and communities and active case-finding by female Health Extension Workers (HEWs) at village level. HEWs conducted house-to-house visits, identified individuals with a cough for two or more weeks, with or without other symptoms, collected sputum, prepared smears and supervised treatment. Supervisors transported smears for microscopy, started treatment, screened contacts and initiated Isoniazid preventive therapy (IPT) for children. Outcomes were compared with the pre-implementation period and a control zone. Qualitative research was conducted to understand community and provider perceptions and experiences. HEWs screened 49,857 symptomatic individuals (60% women) from October 2010 to December 2011. 2,262 (4·5%) had smear-positive TB (53% women). Case notification increased from 64 to 127/100,000 population/year resulting in 5,090 PTB+ and 7,071 cases of all forms of TB. Of 8,005 contacts visited, 1,949 were symptomatic, 1,290 symptomatic were tested and 69 diagnosed with TB. 1,080 children received IPT. Treatment success for smear-positive TB increased from 77% to 93% and treatment default decreased from 11% to 3%. Service users and providers found the intervention package highly acceptable. CONCLUSIONS: Community-based interventions made TB diagnostic and treatment services more accessible to the poor, women, elderly and children, doubling the notification rate and improving treatment outcome. This approach could improve TB diagnosis and treatment in other high burden settings. Public Library of Science 2013-05-27 /pmc/articles/PMC3664633/ /pubmed/23723975 http://dx.doi.org/10.1371/journal.pone.0063174 Text en © 2013 Yassin 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
Yassin, Mohammed A.
Datiko, Daniel G.
Tulloch, Olivia
Markos, Paulos
Aschalew, Melkamsew
Shargie, Estifanos B.
Dangisso, Mesay H.
Komatsu, Ryuichi
Sahu, Suvanand
Blok, Lucie
Cuevas, Luis E.
Theobald, Sally
Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia
title Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia
title_full Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia
title_fullStr Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia
title_full_unstemmed Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia
title_short Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improve Treatment Outcome in Southern Ethiopia
title_sort innovative community-based approaches doubled tuberculosis case notification and improve treatment outcome in southern ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664633/
https://www.ncbi.nlm.nih.gov/pubmed/23723975
http://dx.doi.org/10.1371/journal.pone.0063174
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