부산대학교 도서관

Background Axshya 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. Objectives To 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. Methods This 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. Results We included 234 ACF-diagnosed and 231 PCF-diagnosed patients. When compared to PCF, ACF patients were relatively older ([greater than or equal to]65 years, 14% versus 8%, p = 0.041), had no formal education (57% versus 36%, p Conclusion Axshya SAMVAD linked the most impoverished communities to TB care and resulted in reduction of health system level diagnosis delay.
Author(s): Hemant Deepak Shewade 1,2,*, Vivek Gupta 3, Srinath Satyanarayana 2, Prabhat Pandey 1, U. N. Bajpai 4, Jaya Prasad Tripathy 1,2, Soundappan Kathirvel 1,5, Sripriya Pandurangan 1, Subrat Mohanty [...]