ArticleGlobal health action2018
Impact of community-based adherence support on treatment outcomes for tuberculosis, leprosy and HIV/AIDS-infected individuals in post-Ebola Liberia.
Article in Global health action, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Engagement strategies for people living with leprosy: a scoping review of studies published from 1992 to 2024.Archives of public health = Archives belges de sante publique · 2026Pooled it
- The role of community health worker-based care in post-conflict settings: a systematic review.Health policy and planning · 2023Pooled it
- Study on health seeking behaviour and determinants of undiagnosed hypertension in poor households in the Philippines, part of the RESPOND study (SHARP-RESPOND).PLOS global public health · 2025Article
- Participatory development of Indonesia's national action plan for zero leprosy: strategies and interventions.Frontiers in public health · 2025Article
- Responding to fluctuations in public and community trust and health seeking behaviour during the COVID-19 pandemic: a qualitative study of national decision-makers' perspectives in Guinea and Sierra Leone.BMC public health · 2024Article
- Psychosocial support interventions to improve treatment outcomes for people living with tuberculosis: a mixed methods systematic review and meta-analysis.EClinicalMedicine · 2023Article
- Social Protection Interventions for TB-Affected Households: A Scoping Review.The American journal of tropical medicine and hygiene · 2023Article
- The Association Between Household Financial Burden and Patient Mobility and Their Impact on Loss to Follow-Up Among Multidrug-Resistant Tuberculosis Patients in Guizhou, China.Risk management and healthcare policy · 2023Article
- Spatial patterns and climate drivers of malaria in three border areas of Brazil, Venezuela and Guyana, 2016-2018.Scientific reports · 2022Article
- A scoping review of strategies to support public health recovery in the transition to a "new normal" in the age of COVID-19.BMC public health · 2022Article
- Early Lessons From Launching an Innovative Community Health Household Model Across 3 Country Contexts.Global health, science and practice · 2021Article
- Is patient navigation a solution to the problem of "leaving no one behind"? A scoping review of evidence from low-income countries.Health policy and planning · 2021Article
- Gaps and Opportunities in HIV Service Delivery in High Volume HIV Care Centers in Liberia: Lessons From the Field.Annals of global health · 2021Review
- Effect of a conditional cash transfer programme on leprosy treatment adherence and cure in patients from the nationwide 100 Million Brazilian Cohort: a quasi-experimental study.The Lancet. Infectious diseases · 2020Article
- Does time to loss to follow-up differ among adult tuberculosis patients initiated on tuberculosis treatment and care between general hospital and health centers? A retrospective cohort study.Tropical medicine and health · 2020Article
- Incidence and predictors of LTFU among adults with TB/HIV co-infection in two governmental hospitals, Mekelle, Ethiopia, 2009-2016: survival model approach.BMC infectious diseases · 2019Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPartners In Health (PIH) committed to improving health care delivery in Maryland County, Liberia following the Ebola epidemic by employing 71 community health workers (CHWs) to provide treatment support to tuberculosis (TB), HIV and leprosy patients. PIH simultaneously deployed a socioeconomic assistance program with three core components: transportation reimbursement to clinics; food support; and additional social assistance in select cases.
objectiveThis study aimed to evaluate how a CHW program for community treatment support and addressing socioeconomic barriers to care can impact patient outcomes in a post-conflict and post-epidemic context.
methodsRetrospective observational study utilizing registry data from 513 TB, 447 HIV and 75 leprosy patients at three health facilities in Maryland County, Liberia. Treatment coverage and clinical outcomes for patient cohorts enrolled in the pre-intervention period (January 2015 to June 2015) and the post-intervention period (July 2015 to July 2017) are compared using logistic regression analyses.
resultsTB treatment coverage increased from 7.7% pre-intervention to 43.2% (p < 0.001) post-intervention and lost to follow-up (LTFU) rates decreased from 9.5% to 2.1% (p = 0.003). ART treatment coverage increased 3.8 percentage points (p = 0.03), with patient retention improving 63.9% to 86.1% (p < 0.001); a 6.0 percentage point decrease in HIV LTFU was also observed (p = 0.21). Despite an 84.3% treatment success rate observed for leprosy patients, pre-intervention data was largely unavailable and statistical significance could not be reached for any treatment outcomes pre-post intervention.
conclusionsThe PIH approach to CHW community treatment support in Liberia demonstrates how, with the right inputs, excellent clinical outcomes are possible even in post-conflict and post-epidemic contexts. Care should be taken to position and support CHWs so that they have the opportunity to succeed, including full integration and recognition within the system, and the addition of clinical system improvements and social supports that are too often dismissed as unsustainable.
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