scholarly journals What Makes Community Health Worker Models for Tuberculosis Active Case Finding Work? A Cross-Sectional Study of TB REACH Projects to Identify Success Factors for Increasing Case Notifications

2021 ◽  
Author(s):  
Thu A. Dam ◽  
Rachel Forse ◽  
Phuong M.T. Tran ◽  
Luan N.Q. Vo ◽  
Andrew J. Codlin ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Case Finding ◽  
Active Case Finding ◽  
Who Guidelines ◽  
Sectional Study ◽  
Knowledge Gaps ◽  
Cross Sectional ◽  
Project Impact ◽  
Active Case

Abstract Background In the field of tuberculosis (TB), Community Healthcare Workers (CHWs) have been engaged for advocacy, case detection, and patient support in a wide range of settings. Estimates predict large-sale shortfalls of healthcare workers in low- and middle-income settings by 2030 and strategies are needed to optimize the health workforce to achieve universal availability and accessibility of healthcare. In 2018, the World Health Organization (WHO) published guidelines on best practices for CHW engagement, and identified remaining knowledge gaps. Stop TB Partnership’s TB REACH initiative has supported interventions using CHWs to deliver TB care in over 30 countries, and utilized the same primary indicator to measure project impact at the population-level for all TB active case finding projects, which makes the results comparable across multiple settings. This study compiled 10 years of implementation data from the initiative’s grantee network to begin to address key knowledge gaps in CHW networks. Methods We conducted a cross-sectional study analyzing the TB REACH data repository (n=123) and primary survey responses (n=50) of project implementers. We designed a survey based on WHO guidelines to understand projects’ practices on CHW recruitment, training, activities, supervision, compensation, and sustainability. We segmented projects by TB notification impact and fitted linear random-effect regression models to identify practices associated with higher changes in notifications. Results Most projects employed CHWs for advocacy alongside case finding and holding activities. Model characteristics associated with higher project impact included incorporating e-learning in training and having the prospect of CHWs continuing their responsibilities at the close of a project. Factors that trended towards being associated with higher impact were community-based training, differentiated contracts, and non-monetary incentives. Conclusion In line with WHO guidelines, our findings emphasize that successful implementation approaches provide CHWs with comprehensive training, continuous supervision, fair compensation, and are integrated within the existing primary healthcare system. However, we encountered a great degree of heterogeneity in CHW engagement models, resulting in few practices clearly associated with higher notifications.

scholarly journals What Makes Community Health Worker Models for Tuberculosis Active Case Finding Work? A Cross-sectional Study of TB REACH Projects to Identify Success Factors for Increasing Case Notifications

2021 ◽  
Author(s):  
Thu Dam ◽  
Rachel Forse ◽  
Phuong Tran ◽  
Luan Vo ◽  
Andrew James Codlin ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Case Finding ◽  
Active Case Finding ◽  
Who Guidelines ◽  
Sectional Study ◽  
Knowledge Gaps ◽  
Cross Sectional ◽  
Project Impact ◽  
Active Case

Abstract Background: In the field of tuberculosis (TB), Community Healthcare Workers (CHWs) have been engaged for advocacy, case detection, and patient support in a wide range of settings. Estimates predict large-sale shortfalls of healthcare workers in low- and middle-income settings by 2030 and strategies are needed to optimize the health workforce to achieve universal availability and accessibility of healthcare. In 2018, the World Health Organization (WHO) published guidelines on best practices for CHW engagement, and identified remaining knowledge gaps. Stop TB Partnership’s TB REACH initiative has supported interventions using CHWs to deliver TB care in over 30 countries, and utilized the same primary indicator to measure project impact at the population-level for all TB active case finding projects, which makes the results comparable across multiple settings. This study compiled 10 years of implementation data from the initiative’s grantee network to begin to address key knowledge gaps in CHW networks.Methods: We conducted a cross-sectional study analyzing the TB REACH data repository (n=123) and primary survey responses (n=50) of project implementers. We designed a survey based on WHO guidelines to understand projects’ practices on CHW recruitment, training, activities, supervision, compensation, and sustainability. We segmented projects by TB notification impact and fitted linear random-effect regression models to identify practices associated with higher changes in notifications. Results: Most projects employed CHWs for advocacy alongside case finding and holding activities. Model characteristics associated with higher project impact included incorporating e-learning in training and having the prospect of CHWs continuing their responsibilities at the close of a project. Factors that trended towards being associated with higher impact were community-based training, differentiated contracts, and non-monetary incentives.Conclusion: In line with WHO guidelines, our findings emphasize that successful implementation approaches provide CHWs with comprehensive training, continuous supervision, fair compensation, and are integrated within the existing primary healthcare system. However, we encountered a great degree of heterogeneity in CHW engagement models, resulting in few practices clearly associated with higher notifications.

scholarly journals Performance of algorithms for tuberculosis active case finding in underserved high-prevalence settings in Cambodia: a cross-sectional study

2019 ◽  
Vol 12 (1) ◽  
pp. 1646024
Author(s):  
Kimcheng Choun ◽  
Tom Decroo ◽  
Tan Eang Mao ◽  
Natalie Lorent ◽  
Lisanne Gerstel ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Case Finding ◽  
Active Case Finding ◽  
Sectional Study ◽  
Cross Sectional ◽  
Active Case ◽  
High Prevalence

scholarly journals Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 50
Author(s):  
Suman Chandra Gurung ◽  
Kritika Dixit ◽  
Bhola Rai ◽  
Raghu Dhital ◽  
Puskar Raj Paudel ◽  
...  
Keyword(s):  
Diagnostic Testing ◽  
Scale Up ◽  
Cross Sectional Study ◽  
Case Finding ◽  
Smear Microscopy ◽  
Active Case Finding ◽  
Community Based ◽  
Cross Sectional ◽  
Active Case ◽  
And Control

This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092; 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4; 95%CI = 1.12–1.72; p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally.

scholarly journals Active case finding: community health workers' activity related to tuberculosis control in a large city, brazil

2014 ◽  
Vol 23 (2) ◽  
pp. 261-269 ◽  
Author(s):  
Beatriz Estuque Scatolin ◽  
Erika Simone Galvão Pinto ◽  
Ricardo Alexandre Arcêncio ◽  
Rubia Laine de Paula Andrade ◽  
Anneliese Domingues Wysocki ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Large City ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Case Finding ◽  
Active Case Finding ◽  
Cross Sectional ◽  
Active Case

This study analyzed the Community Health Workers' activity in active case finding in Ribeirão Preto-SP. Cross sectional study, conducted in 2009-2010, with the use of a structured form, which was applied to 105 Community Health Workers and research of secondary data. Indicators were created based on the variable means that used the Likert scale for the answers, being dissatisfactory (scores 1 and 2), regular (3) and satisfactory (4 and 5). Deficiencies in the activity of the Community Workers in the active case finding were identified (mean=3.0), in the discussion with the community about the tuberculosis (mean=1.5) and in the establishment of partnership in the region for the active case finding (mean=1.9). Only 6% of the expected respiratory symptoms in the areas where the units of the participants are located were examined. The results reinforced the need for nursing supervision, a new work logic, with advances in the intersectional articulation, aimed at increasing the detection of tuberculosis cases.

scholarly journals Prevalence of patients with respiratory symptoms through active case finding and diagnosis of pulmonary tuberculosis among prisoners and related predictors in a jail in the city of Carapicuíba, Brazil

2010 ◽  
Vol 13 (4) ◽  
pp. 641-650 ◽  
Author(s):  
Amadeu A. Vieira ◽  
Sandra A. Ribeiro ◽  
Ana M. de Siqueira ◽  
Vera M. N. Galesi ◽  
Laedi A. R. dos Santos ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Respiratory Symptoms ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Case Finding ◽  
Active Case Finding ◽  
Cross Sectional ◽  
Active Case ◽  
Alcohol And Drug Abuse ◽  
Poor Ventilation

BACKGROUND: Prisons offer a fertile setting for the transmission of tuberculosis due to the presence of many classic risk factors for both infection and disease: overcrowding, poor ventilation, and little sunlight. Prisoners are often malnourished and have poor hygiene and are more likely to have a background of alcohol and drug abuse. OBJECTIVES: To determine the prevalence of prisoners with respiratory symptoms and pulmonary tuberculosis (PTB) through active case finding in a prisoner population of the county jail of Carapicuíba, and to study possible related variables. METHODS: This was a cross-sectional study, and respiratory symptomatic individuals (RSI) were detected through active case finding. Socio-demographic data were collected from inmates' judicial history using a specific questionnaire. The RSI provided sputum specimens for detection of acid fast bacilli and culture for mycobacterium identification. RESULTS: Among the 397 prisoners studied, 154 reported respiratory symptoms for more than three weeks, and were considered RSI; the variables associated with RSI were: having already been tried and incarcerated for more than six months and seven were diagnosed as PTB (1,763 cases/ 100,000 inhabitants). CONCLUSIONS: The prevalence of RSI and PTB cases were respectively 39 and 35 times greater than the general population.

scholarly journals Surveillance of Biomedical Waste Practices in a Multi Speciality Hospital, its Evaluation and Audit

2021 ◽  
pp. 133-140
Author(s):  
Ketaki V. Kulkarni ◽  
Niranjan P. Pathak
Keyword(s):  
Study Design ◽  
Nursing Staff ◽  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Knowledge Gaps ◽  
Cross Sectional ◽  
Biomedical Waste ◽  
Repeated Training ◽  
Colour Coding

Aims: To assess the knowledge of Biomedical waste (BMW) categories, colour coding, transport, storage & disposal of Biomedical waste among the healthcare workers. Study Design: Cross sectional. Place and Duration of Study: Multi speciality Hospital, Pune, over the duration of 1 month. Methodology: A predesigned questionnaire containing closed-ended questions was used to conduct this cross sectional study on HCWs. The data related to awareness & knowledge about various aspects of Biomedical waste amongst the Healthcare workers was collected. Results: Out of total 100 Healthcare workers (HCWs), 40 doctors were correctly knowing all the categories of Biomedical waste. 45 doctors & 40 nursing staff (total 85 out of 100 HCWs) could answer correctly the questions on colour coding of BMW. Only 30 doctors & 21 nursing staff could answer correctly about BMW transport. 25 doctors &18 nurses could answer correctly the questions related to BMW storage & disposal. Conclusion: The vigorous & repeated training & evaluation is needed to bridge the observed knowledge gaps amongst the HCWs.

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