Prasad Banuru M, Chadha Sarabjit S, Thekkur Pruthu, Nayak Sashikant, Rajput Vikas S, Ranjan Rajesh, Dayal Rakesh
Tuberculosis and Communicable Disease Department, International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, New Delhi, India.
Department of Microbiology, Foundation for Innovate New Diagnosis (FIND), New Delhi, India.
J Family Med Prim Care. 2020 Jan 28;9(1):259-263. doi: 10.4103/jfmpc.jfmpc_729_19. eCollection 2020 Jan.
Rural healthcare providers (RHCPs) are the first point of contact for majority of patients in rural parts of India. A total of 75 RHCPs were trained and engaged in Hazaribagh to identify presumptive tuberculosis (TB) patients (PrTBPs) and refer them for diagnosis. Patients diagnosed with TB were initiated on directly observed treatment short course (DOTS) under the programme. Based on patients' choice, the treatment providers were either RHCPs or community health workers (CHWs). In this paper, we aim to compare the treatment outcomes of TB patients who received DOTS from RHCPs with CHWs.
This is a retrospective cohort study using secondary data routinely collected through project and Revised National TB Control Programme.
Over the period of 24 months, 57 RHCPs continued to be engaged with project and a total of 382 referrals were made out of which 72 (19%) were diagnosed with TB. Based on choice made, 40 (55%) of TB patients chose RHCPs and 32 (45%) CHWs as their treatment provider. The mean successful treatment completion rate was 87% in the RHCP group compared with 81% for CHWs ( value 0.464). The percentages of unsuccessful outcomes were similar for both groups.
Our study demonstrates the process to engage RHCPs in TB prevention and care. The study highlights community preference for RHCPs as DOT provider who can produce similar TB treatment success rates as that of CHWs identified by programme.
在印度农村地区，农村医疗服务提供者（RHCPs）是大多数患者的首要接触点。在哈扎里巴格，共有75名农村医疗服务提供者接受培训并参与工作，以识别疑似结核病（TB）患者（PrTBPs）并将他们转诊进行诊断。被诊断为结核病的患者在该项目下开始接受直接观察下的短程治疗（DOTS）。根据患者的选择，治疗提供者要么是农村医疗服务提供者，要么是社区卫生工作者（CHWs）。在本文中，我们旨在比较从农村医疗服务提供者和社区卫生工作者处接受DOTS治疗的结核病患者的治疗结果。
这是一项回顾性队列研究，使用通过项目和修订的国家结核病控制计划常规收集的二手数据。
在24个月期间，57名农村医疗服务提供者继续参与该项目，共进行了382次转诊，其中72人（19%）被诊断为结核病。根据患者的选择，40名（55%）结核病患者选择农村医疗服务提供者，32名（45%）选择社区卫生工作者作为他们的治疗提供者。农村医疗服务提供者组的平均成功治疗完成率为87%，而社区卫生工作者组为81%（ 值0.464）。两组的治疗失败率相似。
我们的研究展示了让农村医疗服务提供者参与结核病预防和护理的过程。该研究强调了社区对农村医疗服务提供者作为DOTS提供者的偏好，他们能取得与该项目确定的社区卫生工作者相似的结核病治疗成功率。
