Community-based approaches to improve tuberculosis services: observations from preintervention and postintervention surveys in a high TB burden disadvantaged community in India

Abstract

An alarmingly high prevalence of tuberculosis (TB) was reported among the Saharia tribe in Madhya Pradesh, India. A community-based intervention study was undertaken to improve TB case finding during 2018–2021. The interventions mainly comprised active case detection through village TB volunteers using advocacy, communication and social mobilisation activities. A preintervention and postintervention survey design was adopted to assess the impact of intervention. The prevalence declined from 1357 (95% CI 1206 to 1527) to 752 (95% CI 646 to 875) per 100 000 population (p<0.001). The study findings highlight the importance of innovative community-based approaches in controlling TB in high burden areas. Saharia dominated districts are not included in this list as the Saharia tribe contributes to a small portion to the district’s population. This again makes them more disadvantaged, and it becomes more important to put in special efforts for controlling TB in this disadvantaged population. Our earlier study carried out in a defined geographical area adopting community-based approaches to reach the population and to improve access to services demonstrated a decline in TB prevalence in this community.8 In view of this, an intervention study was conducted covering the total Saharia population of all seven Saharia-dominated districts during 2018–2021 to improve case finding and treatment outcomes through community-based approaches.