The role of active case finding in reducing patient incurred catastrophic costs for tuberculosis in Nepal

Gurung, Suman Chandra; Dixit, Kritika; Rai, Bhola; Caws, Maxine; Paudel, Prajwal; Dhital, Raghu; Acharya, Sunil; Budhathoki, Gangaram; Malla, Deepak; Levy, Jens; Rest, Job van; Lönnroth, Knut; Viney, Kerri; Ramsay, Andrew; Wingfield, Tom; Basnyat, Buddha; Thapa, Ajit; Squire, Bertie; Wang, Duolao; Mishra, Gokul; Shah, Kashim; Shrestha, Anil; Siqueira-Filha, Noemia Teixeira de

doi:10.1186/s40249-019-0603-z

Cited by 47 publications

(84 citation statements)

References 26 publications

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“…However, they would have been diagnosed later, and potentially at greater cost to them and in a poorer state of disease. [22,23] Study limitations include that both intervention and control districts were not randomly selected and may not be representative of all Mozambican health facilities. The existence of differences between intervention and control districts that could explain the results besides the exposure to the intervention cannot be completely excluded.…”

Section: Plos Onementioning

confidence: 99%

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

et al. 2020

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Background Mozambique has one of the highest incidence rates of both TB and HIV in the world and an estimated tuberculosis (TB) treatment coverage of only 57% in 2018. Numerous approaches are being tested to reduce existing gaps in coverage and the estimated number of missing cases. Methods Thirty Community Healthcare Workers (CHWs) were tasked with increasing TB notifications by performing verbal facility-based TB screening of all people presenting for care and TB contact tracing in the community. Using routine National TB Program data, we analyzed trends in TB notifications in five intervention districts and seven control districts in Manica province the year before this project and during a one-year intervention period. Results In the four quarters before the study, the intervention districts notified 5,219 individuals with all forms of TB, and the control districts notified 2,248 TB cases. During the study 5,982 all forms of people with TB were notified in the intervention area, an increase of 763 (14.6%) over the baseline, whereas the control districts notified 1,877 persons with TB, a decrease of-371 (-16.5%). The CHW screening activities yielded 1,502 notified and treated individuals with TB. Conclusions Employing CHWs to promote facility-based TB screening and household contact tracing may lead to an overall increase in TB notification.

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Section: Plos Onementioning

confidence: 99%

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

et al. 2020

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“…The results showed that the economic burden on TB-affected households was high, especially due to costs relating to travel, lost income, and associated with seeking a mixture of both public and private healthcare. The prevalence of catastrophic costs of TB-affected households (total TB associated costs of more than 20% of the same TB-affected household's annual income) [13,43,44] was high in both studies (53% and 49%, respectively) [42].…”

Section: Ongoing Studies Addressing the Socioeconomic Impact Of Tb Inmentioning

confidence: 74%

Developing Feasible, Locally Appropriate Socioeconomic Support for TB-Affected Households in Nepal

et al. 2020

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Tuberculosis (TB), the leading single infectious diseases killer globally, is driven by poverty. Conversely, having TB worsens impoverishment. During TB illness, lost income and out-of-pocket costs can become “catastrophic”, leading patients to abandon treatment, develop drug-resistance, and die. WHO’s 2015 End TB Strategy recommends eliminating catastrophic costs and providing socioeconomic support for TB-affected people. However, there is negligible evidence to guide the design and implementation of such socioeconomic support, especially in low-income, TB-endemic countries. A national, multi-sectoral workshop was held in Kathmandu, Nepal, on the 11th and 12th September 2019, to develop a shortlist of feasible, locally appropriate socioeconomic support interventions for TB-affected households in Nepal, a low-income country with significant TB burden. The workshop brought together key stakeholders in Nepal including from the Ministry of Health and Population, Department of Health Services, Provincial Health Directorate, Health Offices, National TB Program (NTP); and TB/Leprosy Officers, healthcare workers, community health volunteers, TB-affected people, and external development partners (EDP). During the workshop, participants reviewed current Nepal NTP data and strategy, discussed the preliminary results of a mixed-methods study of the socioeconomic determinants and consequences of TB in Nepal, described existing and potential socioeconomic interventions for TB-affected households in Nepal, and selected the most promising interventions for future randomized controlled trial evaluations in Nepal. This report describes the activities, outcomes, and recommendations from the workshop.

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“…In order to improve the diagnosis [32][33][34][35], treatment [36,37] and TB prevention services [38][39][40], a lot of research have been carried out around the world. A study from Nepal found that active case nding could reduce catastrophic costs [41]. And the WHO milestones can only be achieved within the context of progress towards universal health coverage (UHC) [1].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis registration rates analysis and prediction based on exponential smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan province, China?

Zhang

Li³

et al. 2020

Preprint

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Background: The World Health Organization (WHO) End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20% and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854,672 active PTB cases were registered and treated in Henan Province, China. We need to assess whether the WHO milestones could be achieved in Henan Province.Methods: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System (CTIMS) were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted.Results: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter’s multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2-62.0) and 34.4 (95% CI: 18.6-50.2) per 100,000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI: 3.2%-44.1%) and 46.8% (95% CI: 21.4%-72.1%) in 2020 and 2025, respectively.Conclusions: The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the confidence interval, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.

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The role of active case finding in reducing patient incurred catastrophic costs for tuberculosis in Nepal

Cited by 47 publications

References 26 publications

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

Developing Feasible, Locally Appropriate Socioeconomic Support for TB-Affected Households in Nepal

Tuberculosis registration rates analysis and prediction based on exponential smoothing model: could tuberculosis control milestones be achieved in 2020, 2025 in Henan province, China?

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