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Tuberculosis case-finding in Eastern Nepal
Tubercle
|September 1, 1982
Summary
Active case-finding (ACF) in Nepal identified more patients but led to lower treatment completion and cure rates compared to self-referral (SR). ACF patients, often older women, were more likely to default from tuberculosis treatment.
Area of Science:
- Public Health
- Epidemiology
- Tuberculosis Control
Background:
- Tuberculosis (TB) case-finding strategies significantly impact treatment outcomes and patient compliance.
- Understanding the effectiveness of different TB detection methods is crucial for optimizing public health interventions in resource-limited settings.
Purpose of the Study:
- To compare the effectiveness of active case-finding (ACF) versus self-referral (SR) for tuberculosis detection in Eastern Nepal.
- To analyze patient compliance, treatment outcomes, and cure rates associated with each case-finding method.
Main Methods:
- A comparative study was conducted in Eastern Nepal, evaluating ACF by mobile teams against SR to existing services.
- Patient demographics, treatment adherence, default rates, and sputum conversion were analyzed across multiple districts.
Main Results:
- ACF identified more TB patients, who were typically older and included a higher proportion of women, compared to SR.
- ACF patients exhibited significantly higher default rates, particularly older women, and lower treatment completion and sputum conversion rates.
- Proximity to health facilities did not reduce default rates in ACF but improved compliance in SR patients.
Conclusions:
- While ACF increases case detection, it is associated with poorer treatment adherence and outcomes compared to SR in the context of established TB services.
- The findings suggest a need to optimize ACF strategies to improve patient retention and treatment success, especially for vulnerable groups.