Public Health Action最新文献

Role of triage audit in an ongoing differentiated TB care initiative to reduce deaths in Tamil Nadu, India. 分类审计在印度泰米尔纳德邦正在进行的减少死亡的差异化结核病治疗倡议中的作用。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0015

A Jeyakumar, S Kalaiselvi, D Nair, R Vijayaprabha, D Kabir, J M Melfha, T Bhatnagar, R Srinivasan, K Gayathri, K Boopathi, R S Vaman, V Rajan, S Shanmugasundaram, A Frederick, H D Shewade

{"title":"Role of triage audit in an ongoing differentiated TB care initiative to reduce deaths in Tamil Nadu, India.","authors":"A Jeyakumar, S Kalaiselvi, D Nair, R Vijayaprabha, D Kabir, J M Melfha, T Bhatnagar, R Srinivasan, K Gayathri, K Boopathi, R S Vaman, V Rajan, S Shanmugasundaram, A Frederick, H D Shewade","doi":"10.5588/pha.25.0015","DOIUrl":"10.5588/pha.25.0015","url":null,"abstract":"Objective: In the ongoing India's first state-wide differentiated TB care programme in Tamil Nadu (TN-KET), adults diagnosed with drug-sensitive TB at public facilities undergo triage. The adults with severe undernutrition, respiratory insufficiency, or poor performance status are prioritised for comprehensive assessment and inpatient care. Although the programme met triage coverage targets, 11 districts failed to achieve the goal of a 30% reduction in TB death rates. This study compares aggregate triage coverage with actual coverage and evaluates the quality of programme-reported triaging data against an investigator-led audit (repeat assessments in the field) within a few weeks of diagnosis.Design: An ecological study using routine programme data (April 2022-June 2024) was conducted for the first objective, and a cross-sectional analytical study with primary and secondary data (August 2024-February 2025) was performed for the triage audit.Results: Among 48,905 adults with drug-sensitive TB notified, the true triage coverage was 84% against the reported triage coverage of 113%. The triage audit showed 35.7% were triage-positive, compared with 27.6% through TB SeWA (Severe TB Web Application). The mean weight and body mass index from the audit were 0.82 kg and 0.63 kg/m2 lower than TB SeWA data, and oedema was unassessed in 65% of the adults with TB.Conclusion: The districts need to address inadequate triage coverage and suboptimal quality of triaging.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"118-123"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation of BMI field charts for nutritional assessment in adult patients with tuberculosis in Karnataka. 在卡纳塔克邦对成年结核病患者进行营养评估的BMI现场图表的实施。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0017

M Bhargava, K M Akshaya, M N Badarudeen, S B Nagaraja, A Bhargava

{"title":"Implementation of BMI field charts for nutritional assessment in adult patients with tuberculosis in Karnataka.","authors":"M Bhargava, K M Akshaya, M N Badarudeen, S B Nagaraja, A Bhargava","doi":"10.5588/pha.25.0017","DOIUrl":"10.5588/pha.25.0017","url":null,"abstract":"Background: We tested the operational feasibility of body mass index (BMI) field charts in nutritional assessment of adult patients with tuberculosis (PwTB), which obviate calculations and provide nutritional status based on BMI and the ideal weight (BMI = 21 kg/m2).Methods: We trained primary health care providers (HCPs) in 39 primary health centres for nutritional assessment and classification and identifying the ideal weight using BMI field charts in PwTB. Using the descriptive statistics method, we analysed the collected data and reported the nutritional status in PwTB and the uptake of the field charts among the HCPs.Results: The median (interquartile range [IQR]) weight and BMI were 44 kg (37.0, 50.0) and 16.9 kg/m2 (15.2, 18.9), respectively, in 214 PwTB, of which 146 (68.2%) patients had a BMI of <18.5 kg/m2. The HCPs documented the ideal weight in 155 (72.4%) patients, which was correct in 147 (94.8%) patients. The median (IQR) weight deficit to achieve the ideal weight was 10.4 kg (7.3, 12.8) in men and 11.9 kg (7.0, 17.9) in women. For a BMI of 18.5 kg/m2, the deficit was 6.4 kg (3.4, 8.5) in men and 11.3 kg (4.6, 13.6) in women.Conclusion: The magnitude and severity of undernutrition in adult PwTB in a well-performing district of Karnataka in South India were high. A single training session successfully improved nutritional assessment and BMI field chart usage among the primary HCPs.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"103-107"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementing standardised community-based service package to improve TB outcomes in six countries. 在六个国家实施以社区为基础的标准化一揽子服务，以改善结核病结果。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0021

M Volik, L Tonkonoh, Y Kalancha, P Valieva, N Heydarova, D Zhurkin, N Shumskaia, O Bobokhojaev, S Naimov, O Klymenko, S Hasanova, O Rucsineanu

{"title":"Implementing standardised community-based service package to improve TB outcomes in six countries.","authors":"M Volik, L Tonkonoh, Y Kalancha, P Valieva, N Heydarova, D Zhurkin, N Shumskaia, O Bobokhojaev, S Naimov, O Klymenko, S Hasanova, O Rucsineanu","doi":"10.5588/pha.25.0021","DOIUrl":"10.5588/pha.25.0021","url":null,"abstract":"Background: Although the need for community-based support services as part of TB care is reaffirmed in various strategies, there are no data on the implementation progress of the recommended standardised package of community-based support services to improve TB outcomes developed by a consortium of partners in 2021.Methods: The study describes country adaptation and initial planned implementation of the community-based packages in six countries of Eastern Europe and Central Asia - Azerbaijan; the Republic of Belarus (Belarus); the Kyrgyz Republic (Kyrgyzstan); the Republic of Moldova (Moldova); Tajikistan; and Ukraine - using programme review and qualitative data.Results: An analysis of the package adaptation and initial implementation is presented from the perspective of the country implementers with a focus on country-specific approaches and lessons learned. The analysis framework is focused on the following specific areas: 1) adaptation practices; 2) ensuring quality and supervision of the services; and 3) securing funding. Commonalities and differences in each of these areas are analysed.Conclusion: In all countries, standardised community-based service packages were adapted and gradually introduced to support clinical TB care. Proper costing and monitoring of the services delivered at the community levels and integrating the budgeted packages into national TB programmes are recommended to ensure sustainability.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"124-128"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge, enablers, and barriers to TB preventive treatment among health care workers. 卫生保健工作者在结核病预防治疗方面的知识、促进因素和障碍。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.24.0044

O Chukwuogo, O Daniel, A Ihesie, R Eneogu, B Odume, A Agbaje, D Nongo, J Kuye, O Oyelaran, W Van Gemert, L Mupfumi, E Akpanowo, S Asuke, C D'auvergne, O Chijioke-Akaniro, C Anyaike, S Olarewaju

{"title":"Knowledge, enablers, and barriers to TB preventive treatment among health care workers.","authors":"O Chukwuogo, O Daniel, A Ihesie, R Eneogu, B Odume, A Agbaje, D Nongo, J Kuye, O Oyelaran, W Van Gemert, L Mupfumi, E Akpanowo, S Asuke, C D'auvergne, O Chijioke-Akaniro, C Anyaike, S Olarewaju","doi":"10.5588/pha.24.0044","DOIUrl":"10.5588/pha.24.0044","url":null,"abstract":"Background: As part of its TB control efforts, the Nigeria National TB Program has prioritised implementation of TB preventive treatment (TPT) especially among all contacts of TB patients. This study aims to assess knowledge, perceived enablers, and barriers to TPT among health care workers (HCWs) in Nigeria.Methods: This was a cross-sectional descriptive study using mixed methods. Quantitative data were collected from 434 HCWs and analysed using SPSS version 25, and in-depth interviews were conducted on 36 purposely selected HCWs with thematic analysis.Result: More than half of the respondents (55.7%) had good knowledge of TPT. Nurses, doctors, and other HCWs working in public tertiary institutions had better knowledge compared with other cadres. Adequate knowledge of types of TPT regimens and belief in their effectiveness were elicited as enablers, whereas barriers included suboptimal contact tracing system, TPT stock-outs, long duration of TPT, unavailability of TB infection testing before TPT, absence of transport logistics support for patients to receive TPT, and poor HCW capacity.Conclusion: HCWs in public tertiary settings had better knowledge of TPT. Successful scale-up of TPT services requires competency building for other cadres and interventions addressing other identifiable barriers.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"113-117"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Decentralising DR-TB care: the trade-off between quality of care and service coverage in the early phase of implementation. 分散耐药结核病治疗：早期实施阶段护理质量与服务覆盖之间的权衡。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0004

W Jassat, M Moshabela, M P Nicol, L Dickson, H Cox, K Mlisana, J Black, M Loveday, A D Grant, K Kielmann, H Schneider

{"title":"Decentralising DR-TB care: the trade-off between quality of care and service coverage in the early phase of implementation.","authors":"W Jassat, M Moshabela, M P Nicol, L Dickson, H Cox, K Mlisana, J Black, M Loveday, A D Grant, K Kielmann, H Schneider","doi":"10.5588/pha.25.0004","DOIUrl":"10.5588/pha.25.0004","url":null,"abstract":"Background: A policy of decentralised care for drug-resistant TB (DR-TB) was introduced in South Africa in 2011. We describe a trade-off between increasing coverage of services and poor quality of care, in the early phase of policy implementation.Methods: This was a mixed methods case study, comparing implementation in KwaZulu-Natal and Western Cape provinces; with interviews and quantitative analysis of routine DR-TB programme data. We analysed qualitative data, thematically organizing findings into inputs, processes, and outputs to explore how decentralisation influenced quality of DR-TB care.Results: Decentralisation of DR-TB care expanded access across provinces but there was wide variation in pace, planning and structural readiness. Where rapid scale-up outpaced capacity-building, weaknesses in resourcing, workforce, and clinical governance compromised quality of care. Two illustrative examples highlight that decentralisation to inadequately resourced sites resulted in morbidity to patients who did not receive effective monitoring for adverse events; and decentralising services to inadequately capacitated clinicians resulted in incorrect initiation in more complex cases and late referral of clinical complications.Conclusions: Attempts to decentralise DR-TB treatment in the context of complex treatment algorithms and limited health system capacity resulted in trade-offs of care quality. We argue that quality of care should be an essential consideration in early implementation of health programmes.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"97-102"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of social franchising on TB contact investigation and uptake of TB preventive therapy. 社会特许经营对结核病接触者调查和结核病预防治疗的影响。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.24.0054

M Sheshi, B Odume, O Chukwuogo, C Ogbudebe, I Gordon, S Useni, N Nwokoye, M Bajehson, D Nongo, R Eneogu, A Ihesie, U Omo-Emmanuel, S Wadok, R Furth, C Anyaike

{"title":"Impact of social franchising on TB contact investigation and uptake of TB preventive therapy.","authors":"M Sheshi, B Odume, O Chukwuogo, C Ogbudebe, I Gordon, S Useni, N Nwokoye, M Bajehson, D Nongo, R Eneogu, A Ihesie, U Omo-Emmanuel, S Wadok, R Furth, C Anyaike","doi":"10.5588/pha.24.0054","DOIUrl":"10.5588/pha.24.0054","url":null,"abstract":"Background: TB continues to pose significant public health challenges in high-burden regions such as Kano State, Nigeria, where private health sector engagement in TB control is notably lacking. The Social Franchising for TB Contact Investigation (SOFT) model was introduced to leverage private healthcare to increase the reach and efficacy of TB control efforts.Methods: This nine-month project supported mapping health facilities, training of community health workers and systematic TB contact screening. The SOFT model aimed to enhance TB control by integrating private healthcare facilities and community-based organisations to improve TB yield, contact investigation and uptake of TB Preventive Therapy (TPT).Results: The project showed a consistent increase in TB case detection, with a significant rise in index TB cases identified and their contacts screened each quarter. There was also a marked increase in the number of household contacts screened and initiated on TPT, demonstrating the model's effectiveness in enhancing TB control efforts.Conclusion: The integration of social franchising with community and private healthcare engagement presents a scalable and innovative approach to improving TB control in high-burden settings. This model contributes significantly to global TB elimination efforts by improving detection rates and TPT uptake.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"108-112"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

India's tobacco control law: implementation of prohibition by educational institutions. 印度控烟法：教育机构实施禁烟。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0013

R Singh, A L Frank

引用次数: 0

Clinical diagnosis of TB: further examples of under- and over-diagnosis. 结核病的临床诊断：诊断不足和过度的进一步例子。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0023

A D Harries

引用次数: 0

Use of trained African giant pouched rats as a predictor of clinical diagnosis of pulmonary TB. 使用训练过的非洲巨袋大鼠作为肺结核临床诊断的预测因子。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0010

J Soka, S Mwimanzi, C D Fast, G Mwesiga, N Edward, M Stephen, R Kondo, C Cox, N Beyene, T B Agizew

引用次数: 0

Improving TB care services among coal mine workers and their associated communities in Pakistan. 改善巴基斯坦煤矿工人及其相关社区的结核病治疗服务。

IF 1.6

Public Health Action Pub Date : 2025-09-03 eCollection Date: 2025-09-01 DOI: 10.5588/pha.25.0011

K U Eman, G N Kazi, Z Z Qin, J Creswell, S A Raisani, U R Lodhi, N A Vasquez, S John

{"title":"Improving TB care services among coal mine workers and their associated communities in Pakistan.","authors":"K U Eman, G N Kazi, Z Z Qin, J Creswell, S A Raisani, U R Lodhi, N A Vasquez, S John","doi":"10.5588/pha.25.0011","DOIUrl":"10.5588/pha.25.0011","url":null,"abstract":"Setting: Five major coal mining districts in Balochistan, Pakistan.Objectives: To assess burden of TB among coal miners and their associated communities and establish linkages with TB care services.Design: A cross-sectional study was conducted to find TB cases through active case finding. The target population included people working at coal mining sites and surrounding communities residing within 10 km, including coal miners' families and other individuals. Verbal symptom screening was carried out via mobile camps and community outreach. Sputum was collected from screened positive individuals and tested for TB on GeneXpert. TB cases diagnosed were linked with TB care services.Results: A total of 14,541 individuals including 8,149 (56%) coal miners were screened. Of the people screened, 81% were male, median age was 31 years, 2,274 (15.6%) had TB symptoms, and 34 confirmed TB cases were diagnosed. All 34 TB patients were linked to care and 32 completed treatments successfully. The estimated TB prevalence was 234 cases per 100,000 population (95% confidence interval: 150.6-316.5), with no significant difference between coal miners and associated communities.Conclusion: Similar TB prevalence among coal miners and associated communities reflects shared vulnerability. Use of more sensitive screening tools is recommended to validate prevalence estimates in future studies.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"129-134"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0