Implementation of a tuberculosis elimination project, India 2018-2019

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Systems Research

Background:

• Private sector engagement is crucial for tuberculosis control in India.
• The Joint Effort for Elimination of Tuberculosis project aimed to enhance private sector participation.
• Understanding changes in tuberculosis notifications is key to evaluating such interventions.

Purpose of the Study:

• To evaluate the impact of the Joint Effort for Elimination of Tuberculosis project on tuberculosis case notifications.
• To assess changes in private provider reporting and microbiological confirmation rates.
• To compare tuberculosis notification trends in project-implemented districts versus non-project districts.

Main Methods:

• Utilized data from India's national tuberculosis surveillance system for 95 project districts across six states.
• Analyzed tuberculosis notifications, private notifiers, and microbiological confirmations from 2017 (baseline) to 2019.
• Compared case notification rates between project and non-project districts.

Main Results:

• Tuberculosis notifications surged by 138.1% (44,695 to 106,404) from 2017-2019.
• Private notifiers more than tripled, and microbiologically confirmed cases increased significantly.
• Project districts saw a 150.3% rise in case notification rates, compared to 89.8% in non-project districts.

Conclusions:

• The project effectively increased tuberculosis notifications by engaging the private sector.
• Scaling up these private sector engagement strategies is vital for tuberculosis elimination efforts.
• The findings underscore the importance of public-private partnerships in infectious disease control.