ABSTRACT
Background: In an urban area of a north Indian district (population 150,000), nine private practitioners of non-allopathic medicine, including five with no qualification and two private paramedical staff, were trained as per programme guidelines before being involved as treatment observers in the DOTS-based Revised National TB Control Programme and supervised. They were not given any financial incentive. Material and Methods: During 2002, they managed 185 TB patients (85% of the cases in the urban area) and amongst the 63 new smear-positive patients, the cure rate was 84%. Over a 6 month period, 6% of the total new smear-positive patients detected in the area were referred by these private practitioners. Results: Results suggest that non-allopathic practitioners and paramedical staff from the private sector can make a significant contribution to TB control, by increasing case detection and treatment observation.
ABSTRACT
Setting – A Tuberculosis Unit (TU) with a population of 600,000 in Gurgaon district, Haryana. Objective - To compare the treatment success rate among TB patients taking DOT from community-based Angan-wari workers (AWWs) with that of TB patients with other DOT providers. Design - AWWs were given a two-day modular training, included in the local DOT directory and were directly supervised by the TB Programme staff. From the TB register held at the TU, treatment outcomes of all new sputum positive (NSP) patients registered in Gurgaon TU from 1st January to 31st December 2002, were evaluated. Results - During 2002, AWWs observed the treatment of 115 (11%) patients in the TU. The cure rate amongst the 41 NSP patients, who had AWWs as DOT providers, was significantly better than for those who had other DOT providers (95% vs. 78%) respectively (p=0.02). Conclusion - Community-based Angan-wari workers, with adequate training and regular supervision, can contribute effectively to a TB programme as DOT providers.