학술논문
Patient characteristics, health seeking and delays among new sputum smear positive TB patients identified through active case finding when compared to passive case finding in India.
Document Type
article
Author
Hemant Deepak Shewade; Vivek Gupta; Srinath Satyanarayana; Prabhat Pandey; U N Bajpai; Jaya Prasad Tripathy; Soundappan Kathirvel; Sripriya Pandurangan; Subrat Mohanty; Vaibhav Haribhau Ghule; Karuna D Sagili; Banuru Muralidhara Prasad; Sudhi Nath; Priyanka Singh; Kamlesh Singh; Ramesh Singh; Gurukartick Jayaraman; P Rajeswaran; Binod Kumar Srivastava; Moumita Biswas; Gayadhar Mallick; Om Prakash Bera; K N Sahai; Lakshmi Murali; Sanjeev Kamble; Madhav Deshpande; Naresh Kumar; Sunil Kumar; A James Jeyakumar Jaisingh; Ali Jafar Naqvi; Prafulla Verma; Mohammed Salauddin Ansari; Prafulla C Mishra; G Sumesh; Sanjeeb Barik; Vijesh Mathew; Manas Ranjan Singh Lohar; Chandrashekhar S Gaurkhede; Ganesh Parate; Sharifa Yasin Bale; Ishwar Koli; Ashwin Kumar Bharadwaj; G Venkatraman; K Sathiyanarayanan; Jinesh Lal; Ashwini Kumar Sharma; Raghuram Rao; Ajay M V Kumar; Sarabjit Singh Chadha
Source
PLoS ONE, Vol 14, Iss 3, p e0213345 (2019)
Subject
Language
English
ISSN
1932-6203
Abstract
BackgroundAxshya SAMVAD is an active tuberculosis (TB) case finding (ACF) strategy under project Axshya (Axshya meaning 'free of TB' and SAMVAD meaning 'conversation') among marginalized and vulnerable populations in 285 districts of India.ObjectivesTo compare patient characteristics, health seeking, delays in diagnosis and treatment initiation among new sputum smear positive TB patients detected through ACF and passive case finding (PCF) under the national TB programme in marginalized and vulnerable populations between March 2016 and February 2017.MethodsThis observational analytic study was conducted in 18 randomly sampled Axshya districts. We enrolled all TB patients detected through ACF and an equal number of randomly selected patients detected through PCF in the same settings. Data on patient characteristics, health seeking and delays were collected through record review and patient interviews (at their residence). Delays included patient level delay (from eligibility for sputum examination to first contact with any health care provider (HCP)), health system level diagnosis delay (from contact with first HCP to TB diagnosis) and treatment initiation delays (from diagnosis to treatment initiation). Total delay was the sum of patient level, health system level diagnosis delay and treatment initiation delays.ResultsWe included 234 ACF-diagnosed and 231 PCF-diagnosed patients. When compared to PCF, ACF patients were relatively older (≥65 years, 14% versus 8%, p = 0.041), had no formal education (57% versus 36%, pConclusionAxshya SAMVAD linked the most impoverished communities to TB care and resulted in reduction of health system level diagnosis delay.