Archive for the ‘Tuberculosis’ Category

Better tuberculosis control

Friday, May 8th, 2009

One of the main strategies to control tuberculosis is to find and treat people with active disease. Unfortunately, the case detection rates remain low in many countries. Thus, we need interventions to find and treat sufficient number of patients to control tuberculosis.

We investigated whether involving health extension workers (HEWs: trained community health workers) in tuberculosis control improved smear-positive case detection and treatment success rates in southern Ethiopia.

We carried out a community-randomized trial in southern Ethiopia. Involving community health workers in tuberculosis control improved the case detection and treatment success rates for smear-positive patients and for women in particular.

We think our approach improved service access, and recommend this could be applied in settings with low health service coverage and a shortage of health workers.
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Datiko DG, Lindtjørn B (2009) Health Extension Workers Improve Tuberculosis Case Detection and Treatment Success in Southern Ethiopia: A Community Randomized Trial. PLoS ONE 4(5): e5443. doi:10.1371/journal.pone.0005443

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Intervention studies

Saturday, April 4th, 2009

During the past years there has been many papers on patient and treatment delay of tuberculosis. The reasons for delay seem to be with the patient: Delay is often associated with illiteracy, distance from the health institution, gender, poverty, and knowledge about tuberculosis.

Over the years, we have also published on this topic. However, I now doubt if we a need for any more cross-sectional studies. I often receive questions from editors to review such papers, and they do not contain anything new.

So, this raises the question on how many descriptive studies do we need before doing anything for the patients? Does a study showing any association between lack of knowledge on tuberculosis prove that educating the population would reduce delay? I doubt that we can make such a conclusion.

More emphasis should be on how to reduce delay. We need more intervention studies. And these intervention studies should focus on the providers’, and not on the patients’ side. One example of an intervention study is by Estifanos Birru. He showed that active case finding reduces patient delay.

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