Singh Alka Aggarwal, Creswell Jacob, Bhatia Vineet
Independent Senior Public Health Consultant, New Delhi, India.
Stop TB Partnership, Geneva, Switzerland.
PLOS Glob Public Health. 2021 Nov 23;1(11):e0000073. doi: 10.1371/journal.pgph.0000073. eCollection 2021.
There was an estimated 20-40% decline in tuberculosis (TB) case detection in the South-East Asia Region (SEA Region) during 2020 due to COVID-19 outbreak. This is over and above a million people with TB who were missed each year, prior to the pandemic. Active case finding (ACF) for TB has been gaining considerable interest and investment in the SEA Region and will be even more essential for finding people with TB missed due to the COVID-19 pandemic. Many countries in the Region have incorporated ACF activities into national strategic plans and are conducting large scale activities with varying results. ACF can reach people with TB earlier than routine approaches, can lead to increases in the numbers of people diagnosed, and is often needed for certain key populations who face stigma, social, and economic barriers. However, ACF is not a one size fits all approach, and has higher costs than routine care. So, planning interventions in consultation with relevant stakeholders including the affected communities is critical. Furthermore, continuous monitoring during the intervention and after completion is crucial as national TB programmes review progress and decide on the effective utilization of limited resources. Planning and monitoring become more relevant in the COVID-19 era because of constraints posed by resource diversion towards pandemic control. Here, we summarize different aspects of planning and monitoring of ACF approaches to inform national TB programmes and partners based on experiences in the SEA Region, as programmes look to reach those who are missed and catch-up on progress towards ending TB.
由于2020年新冠疫情爆发,东南亚区域(SEA区域)的结核病(TB)病例发现率估计下降了20%-40%。这是在疫情之前每年就有超过100万结核病患者未被发现的基础上。结核病的主动病例发现(ACF)在东南亚区域已引起相当大的关注并得到投资,对于发现因新冠疫情而未被发现的结核病患者将更加重要。该区域许多国家已将主动病例发现活动纳入国家战略计划,并正在开展大规模活动,结果各不相同。主动病例发现比常规方法能更早地发现结核病患者,可导致诊断人数增加,对于面临耻辱感、社会和经济障碍的某些关键人群通常是必要的。然而,主动病例发现并非适用于所有情况的方法,且成本高于常规护理。因此,与包括受影响社区在内的相关利益攸关方协商规划干预措施至关重要。此外,在干预期间和完成后持续监测至关重要,因为国家结核病规划要审查进展情况并决定有限资源的有效利用。由于资源转向疫情防控带来的限制,在新冠疫情时代,规划和监测变得更加重要。在此,我们根据东南亚区域的经验总结主动病例发现方法规划和监测的不同方面,以便为国家结核病规划和合作伙伴提供信息,因为各规划希望找到那些未被发现的患者并追赶终结结核病的进展。