ArticleBMJ open2020
Prediagnostic loss to follow-up in an active case finding tuberculosis programme: a mixed-methods study from rural Bihar, India.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Community views on active case finding for tuberculosis in low- and middle-income countries: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2024Pooled it
- Presumptive pulmonary tuberculosis cases loss to follow up before diagnosis and its associated factors in tertiary care institute.Journal of family medicine and primary care · 2026Article
- Trends and determinants of unfavourable outcomes in paediatric tuberculosis: insights from a 20-year cohort in Cameroon.BMJ open respiratory research · 2025Article
- Integrated health checks as a person-centred approach to systematic screening of household tuberculosis contacts: A realist-informed mixed-methods study.PLOS global public health · 2025Article
- Facilitators and barriers for completion of the diagnostic process among people with presumed tuberculosis in Central Uganda.PLOS global public health · 2025Article
- Article
- Case fatality among people with drug-susceptible TB enrolled in a private health sector TB treatment support program in Bihar, India during the first year of the COVID-19 pandemic.PLOS global public health · 2024Article
- A systematic review and meta-analysis of active case finding for tuberculosis in India.The Lancet regional health. Southeast Asia · 2022Article
- "I lost my faith and stopped taking the medicines" - need for an intervention model based on health belief constructs for improving adherence to tuberculosis treatment.Journal of family medicine and primary care · 2022Article
- Increasing TB/HIV Case Notification through an Active Case-Finding Approach among Rural and Mining Communities in Northwest Tanzania.Journal of tropical medicine · 2022Article
- Can Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation Research from India.Tropical medicine and infectious disease · 2021Article
- Framework for planning and monitoring active TB case finding interventions to meet the global targets in the COVID-19 era and beyond: South-East Asia perspective.PLOS global public health · 2021Review
- Case finding strategies under National Tuberculosis Elimination Programme (NTEP).The Indian journal of tuberculosis · 2020Review
- The TB REACH Initiative: Supporting TB Elimination Efforts in the Asia-Pacific.Tropical medicine and infectious disease · 2020Article
- Article
- Treatment outcomes of tuberculosis patients detected by active case finding under the Revised National Tuberculosis Control Programme during 2018 in Haridwar district of Uttarakhand.Journal of family medicine and primary care · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify the prediagnostic loss to follow-up (PDLFU) in an active case finding tuberculosis (TB) programme and identify the barriers and enablers in undergoing diagnostic evaluation.
designExplanatory mixed-methods design.
settingA rural population of 1.02 million in the Samastipur district of Bihar, India.
participantsBased on their knowledge of health status of families, community health workers or CHWs (called accredited social health activist or locally) and informal providers referred people to the programme. The field coordinators (FCs) in the programme screened the referrals for TB symptoms to identify presumptive TB cases. CHWs accompanied the presumptive TB patients to free diagnostic evaluation, and a transport allowance was given to the patients. Thereafter, CHWs initiated and supported the treatment of confirmed cases. We included 13 395 community referrals received between January and December 2018. To understand the reasons of the PDLFU, we conducted in-depth interviews with patients who were evaluated (n=3), patients who were not evaluated (n=4) and focus group discussions with the CHWs (n=2) and FCs (n=1). OUTCOME MEASURES: Proportion and characteristics of PDLFU and association of demographic and symptom characteristics with diagnostic evaluation.
resultsA total of 11 146 presumptive TB cases were identified between January and December 2018, out of which 4912 (44.1%) underwent diagnostic evaluation. In addition to the free TB services in the public sector, the key enablers were CHW accompaniment and support. The major barriers identified were misinformation and stigma, deficient family and health provider support, transport challenges and poor services in the public health system.
conclusionFinding the missing cases will require patient-centric diagnostic services and urgent reform in the health system. A community-oriented intervention focusing on stigma, misinformation and patient support will be critical to its success.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.