ArticleJournal of global health2021
Community health workers augment the cascade of TB detection to care in urban slums of two metro cities in India.
Article in Journal of global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effective community-based interventions to prevent and control infectious diseases in urban informal settlements in low- and middle-income countries: a systematic review.Systematic reviews · 2024Pooled it
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Effectiveness of a structured gastric aspirate training on diagnosis of paediatric tuberculosis among healthcare workers in rural Chhattisgarh.The Indian journal of medical research · 2026Article
- "Fragmented care pathway in a layered TB care system": a grounded theory approach to understand care pathways and delays in TB care in Odisha.BMC health services research · 2026Article
- Article
- Interprofessional collaboration between pharmacists and community health workers: a scoping review.International journal for equity in health · 2025Article
- Tackling public health data gaps through Bayesian high-resolution population estimation: A case study of Kasaï-Oriental, Democratic Republic of the Congo.PLOS global public health · 2025Article
- Active screening of presumptive tuberculosis cases in rural communities through youth club members in India: logic model development and feasibility study.Frontiers in public health · 2025Article
- Article
- A mixed methods evaluation of a differentiated care model piloted for TB care in south India.Journal of public health research · 2023Article
- Tuberculosis treatment outcomes and patient support groups, southern India.Bulletin of the World Health Organization · 2023Article
- Awareness about tuberculosis in a rural area of Mandya district: A cross-sectional study in southern Karnataka.Journal of family medicine and primary care · 2022Article
- Engagement and Preparedness of Urban Accredited Social Health Activists (U-ASHAs) for Delivery of Tuberculosis (TB) Care: Findings From two Cities in Maharashtra, India.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
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Authors and funding
14 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculosis Health Action Learning Initiative (THALI) funded by USAID is a person-centered initiative, supporting vulnerable urban populations to gain access to TB services. THALI trained and placed 112 Community health workers (CHWs) to detect and support individuals with TB symptoms or disease within urban slums in two cities, Hyderabad and Bengaluru, covering a population of about 3 million.
methodsCHWs visited the slums once in a fortnight. They conducted TB awareness activities. They referred individuals with TB symptoms for sputum testing to nearest public sector laboratories. They visited those testing TB positive, once a fortnight in the intensive phase, and once a month thereafter. They supported TB patients and families with counselling, contact screening and social scheme linkages. They complemented the shortfall in urban TB government field staff numbers and their capacity to engage with TB patients. Data on CHWs' patient referral for TB diagnosis and treatment support activities was entered into a database and analyzed to examine CHWs' role in the cascade of TB care. We compared achievements of six monthly referral cohorts from September 2016 to February 2019.
resultsOverall, 31 617 (approximately 1%) of slum population were identified as TB symptomatic and referred for diagnosis. Among the referred persons, 23 976 (76%) underwent testing of which 3841 (16%) were TB positive. Overall, 3812 (99%) were initiated on treatment and 2760 (72%) agreed for regular follow up by the CHWs. Fifty-seven percent of 2952 referred were tested in the first cohort, against 86% of 8315 in the last cohort. The annualized case detection rate through CHW referrals in Bengaluru increased from 5.5 to 52.0 per 100 000 during the period, while in Hyderabad it was 35.4 initially and increased up to 118.9 per 100 000 persons. The treatment success rate was 87.1% among 193 in the first cohort vs 91.3% among 677 in the last cohort.
conclusionsCHWs in urban slums augment TB detection to care cascade. Their performance and TB treatment outcomes improve over time. It would be important to examine the cost per TB case detected and successfully treated.
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