Enablers and Challenges in the Implementation of Active Case Findings in a Selected District of Karnataka, South India: A Qualitative Study.

Autor: Shamanewadi AN; Department of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, India., Naik PR; Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore Pin-575018, India., Thekkur P; Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris Pin-75006, France.; Centre for Operational Research, The Union South-East Asia Office, New Delhi Pin-110016, India., Madhukumar S; Department of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, India., Nirgude AS; Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore Pin-575018, India., Pavithra MB; Department of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, India., Poojar B; Department of Pharmacology, Kasturba Medical College, Mangalore Pin-575003, India., Sharma V; Monitoring and Evaluation Division, THALI, JSI India, West Bengal Pin: 700107, India., Urs AP; Department of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, India., Nisarga BV; Department of Community Medicine, MVJ Medical College and Research Hospital (MVJMCRH), Dandupalya, Hoskote, Bengaluru Rural Pin-562114, India., Shakila N; District Tuberculosis Officer, Bengaluru Rural District, Bengaluru, India., Nagaraja SB; Department of Community Medicine, ESIC Medical College and PGIMSR, Bengaluru Pin-560010, India.
Jazyk: angličtina
Zdroj: Tuberculosis research and treatment [Tuberc Res Treat] 2020 Jan 24; Vol. 2020, pp. 9746329. Date of Electronic Publication: 2020 Jan 24 (Print Publication: 2020).
DOI: 10.1155/2020/9746329
Abstrakt: Background: Active case finding (ACF) for tuberculosis (TB) is a promising tool to enhance early case detection among marginalized populations. As opposed to passive case finding, it involves systematically searching for TB in individuals who would not spontaneously present for care. The National TB Program (NTP) of India has initiated ACF for TB through the existing general health system since the end of 2017. However, prior to scale-up, there is need for exploring the implementation challenges and solutions to improve the efficiency of this program.
Objectives: (1) To explore the enablers and challenges in the implementation of ACF for TB by NTP in the Bengaluru rural district of Karnataka, South India, and (2) to explore the perceived solutions to improve the efficiency of ACF activity.
Methods: A qualitative descriptive study was conducted in the Bengaluru rural district during July 2018. In-depth interviews using purposively selected health care providers involved in active case finding ( n = 9) and presumptive TB patients ( n = 9) and presumptive TB patients (.
Results: The challenges in conduct of ACF were as follows: inadequate training of health care workers, shortage of staff, indifferent attitude of community due to stigma, lack of awareness about TB, illiteracy, inability to convince patients for sputum test, and delay in getting CBNAAT results. The field staff recommended the installation of mobile CBNAAT machine, involvement of general health staff in activity, training of health workers on counseling of patients, and issue of identity cards for community health workers/volunteers so that people recognize them.
Conclusion: The health system challenges in conduct of ACF need to be addressed by training the health staff involved in activity and also improving the access to TB diagnostics.
Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper.
(Copyright © 2020 Amrita N. Shamanewadi et al.)
Databáze: MEDLINE
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