Control of tuberculosis by community health workers in Bangladesh.
Background Tuberculosis remains a major public-health problem in Bangladesh, despite national efforts to improve case identification and treatment compliance.
In 1984, BRAC (formerly the Bangladesh Rural Advancement Committee), a national, non-governmental organisation, began an experimental tuberculosis-control programme in one thana (subdistrict).
Community health workers screened villagers for chronic cough and collected sputum samples for acid-fast bacillus (AFB) microscopy (phase one).
Positive patients received 12 months of directly observed therapy.
Phase two (1992-94) included another nine thanas and, in phase three (1995), eight more thanas were included.
From 1995, the treatment was an 8-month oral regimen.
Methods In 1995-96, we analysed all programme data from 1992 to 1995.
First we analysed phases two (12-month therapy) and three (8-month therapy) separately for proportion cured, died, treatment failed, defaulted, migrated, and referred.
Second, we did a cross-sectional survey of tuberculosis cases in more than 9000 randomly selected households in two phase-two thanas and one non-programme thana, and analysed the follow-up of all patients treated in the programme thanas.
Findings In the phase-two analysis, 3497 (90%) of 3886 cases identified had accepted 12-month treatment.
In phase three, all of 1741 identified cases accepted the 8-month regimen. 2833 (81.0%) and 1496 (85.9%) in phases two and three, respectively, were cured ; 336 (9.6%) and 133 (7. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Epidémiologie, Prévalence, Campagne de masse, Agent santé, Communauté, Programme contrôle, Randomisation, Etude transversale, Evaluation, Homme, Bengla Desh, Asie, Education santé, Organisation santé
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Epidemiology, Prevalence, Mass campaign, Health worker, Community, Checking program, Randomization, Cross sectional study, Evaluation, Human, Bangladesh, Asia, Health education, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0397968
Code Inist : 002B05B02O. Création : 12/09/1997.