Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug 1:3:27.
doi: 10.1186/2049-9957-3-27. eCollection 2014.

Community based interventions for the prevention and control of tuberculosis

Ahmed Arshad  1 , Rehana A Salam  1 , Zohra S Lassi  1 , Jai K Das  1 , Imama Naqvi  1 , Zulfiqar A Bhutta  2
Affiliations

Community based interventions for the prevention and control of tuberculosis

Ahmed Arshad et al. Infect Dis Poverty. .

Abstract

In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.

Keywords: CHWs; Community-based interventions; DOTS; Tuberculosis; integrated delivery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Search flow diagram.
Figure 2
Figure 2
Forest plot for the impact of CBI on TB case detection.
Figure 3
Figure 3
Forest plot for the impact of CBI on treatment success rate.
See this image and copyright information in PMC

References

    1. World Health Organization. Global Tuberculosis Report. 2013. Availabel at http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf?ua=1.
    1. WHO. Global Tuberculosis Control: Epidemiology, Strategy, Financing: WHO, 2009. Geneva, Switzerland: WHO; 2009.
    1. Rose AM, Watson JM, Graham C, Nunn AJ, Drobniewski F, Ormerod LP, Darbyshire JH, Leese J. Tuberculosis at the end of the 20th century in England and Wales: results of a national survey in 1998. Thorax. 2001;56(3):173–179. - PMC - PubMed
    1. Schluger NW, Burzynski J. Tuberculosis and HIV infection: epidemiology, immunology, and treatment. HIV Clin Trials. 2001;2(4):356–365. - PubMed
    1. WHO. WHO. Geneva: World Health Organization; 2003. Community contribution to TB care: practice and policy.

LinkOut - more resources