PLoS ONE
Volume 13, Issue 5, 2018
Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India (Article) (Open Access)
Dutta A.* ,
Pattanaik S. ,
Choudhury R. ,
Nanda P. ,
Sahu S. ,
Panigrahi R. ,
Padhi B.K. ,
Sahoo K.C. ,
Mishra P.R. ,
Panigrahi P. ,
Lekharu D. ,
Stevens R.H.
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a
Asian Institute of Public Health, Bhubaneswar, India, Indian Institute of Public Health, Public Health Foundation of India Bhubaneswar, India
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b
Asian Institute of Public Health, Bhubaneswar, India
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c
Asian Institute of Public Health, Bhubaneswar, India
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d
Asian Institute of Public Health, Bhubaneswar, India
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e
Stop TB Partnership, Geneva, Switzerland
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f
WHO-RNTCP Technical Assistance Network, Odisha, India
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g
Asian Institute of Public Health, Bhubaneswar, India
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h
Asian Institute of Public Health, Bhubaneswar, India
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i
Asian Institute of Public Health, Bhubaneswar, India
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j
University of Nebraska Medical Centre, Omaha, NE, United States
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k
Independent consultant, Geneva, Switzerland
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l
Independent consultant, Geneva, Switzerland
Abstract
Background Migrant labourers living in the slums of urban and industrial patches across India make up a key sub-population so far controlling Tuberculosis (TB) in the country is concerned. This is because many TB patients from these communities- remain under reached by the Revised National Tuberculosis Control Programme (RNTCP) of India. This marginalized community usually seeks early-stage healthcare from “friendly neighbourhood” non-formal health providers (NFHPs). Because, RNTCP has limited capacity to involve the NFHPs, an implementation research project was conceived, whereby an external partner would engage with the NFHPs to enable them to identify early TB symptomatics from this key sub-population who would be then tested using Xpert MTB/RIF technology. Diagnosed TB cases among them would be referred promptly to RNTCP for treatment. This paper aimed to describe the project and its impact. Methods Adopting a quasi-experimental before-after design, four RNTCP units from two major urban-industrial areas of Odisha were selected for intervention, which spanned five quarters and covered 151,400 people, of which 30% were slum-dwelling migrants. Two similar units comprised the control population. The hypothesis was, reaching the under reached in the intervention area through NFHPs would increase TB notification from these traditionally under-notifying units. RNTCP notification data during intervention was compared with pre-intervention era, adjusted for contemporaneous changes in control population Results The project detected 488 Xpert + TB cases, of whom 466 were administered RNTCP treatment. This translated into notification of additional 198 new bacteriologically positive cases to RNTCP, a 30% notification surge, after adjustment for 2% decline in control. This meant an average quarterly increase in notification of 41.20(20.08, 62.31; p<0.001) cases. The increase was immediate, evident from the rise in level in the time series analysis by 50.42 (10.28, 90.55; p = 0.02) cases. Conclusion Engagement with NFHPs contributed to an increase in TB notification to RNTCP from key under reached, slum-dwelling migrant populations. © 2018 Dutta et al. 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 credited.
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Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047462123&doi=10.1371%2fjournal.pone.0196067&partnerID=40&md5=d236ff27916000f6097cd46c06371956
DOI: 10.1371/journal.pone.0196067
ISSN: 19326203
Original Language: English