Pharmacy based surveillance for identifying missing tuberculosis cases: A mixed methods study from South India.

Area of Science:

• Public Health
• Epidemiology
• Health Policy Implementation

Background:

• Limited Indian research exists on pharmacy-based surveillance for tuberculosis (TB) notification.
• Recent policies aim to leverage pharmacies for TB surveillance, but their impact is unassessed.

Purpose of the Study:

• To evaluate pharmacy-based TB surveillance and notification in India.
• To understand program managers' and pharmacists' experiences with implementation.

Main Methods:

• A mixed-methods approach combining quantitative (cross-sectional) and qualitative (in-depth interviews) data.
• Study conducted in Dharmapuri and Salem districts, Tamil Nadu, India.

Main Results:

• Pharmacies reported anti-TB drug sales, identifying 20-29% of total notified TB patients as previously un-notified.
• Key enablers included understanding notification importance, resources, training, and partnerships.
• Barriers involved patient confidentiality concerns, complex reporting, and high workload.

Conclusions:

• Pharmacy-based surveillance significantly contributes to TB notification, identifying approximately one-fourth of cases in the studied districts.
• Implementation requires strengthening and scaling up across India to enhance TB control.