[A patient-centered approach to tuberculosis control in Burkina Faso]

The Burkina Faso health system is divided into 55 health districts (DS), each with more than 10 primary care health centers (CSPS) that comprise the first level of the health care system. For this study, we chose two intervention districts (one rural, one urban) and two control districts.

To evaluate the impact of the patient-centered approach to tuberculosis control on the detection and treatment of tuberculosis.

This intervention, defined in a consensus process by various participants in tuberculosis management, was implemented in two districts (one rural and one urban). Study outcomes were measured before and after the intervention in two intervention districts and two control districts.

The proportion of patients suspected of tuberculosis who chose sputum sampling in the CSPS was higher in the rural district (Gorom-Gorom) than in the urban one (Pissy): 46% versus 18.7% (p < 0.001). Detection improved more in the intervention than control districts (59% versus 20%). The increase in diagnosis was better in the intervention districts than in their matched control districts (46% versus 5% in the rural district; 75% versus 32% in the urban district). The treatment success rate was better in the rural district's decentralized CSPSs than in its CDTs (Gorom-Gorom) (61.8% vs 52.8%), while the reverse was true in the urban district (Pissy) (75% vs 83.1%).

Detection of new tuberculosis cases increased throughout this study. Improvement in treatment regularity was limited. A longer intervention is needed to evaluate the effects of this approach on treatment results.