International non-governmental organizations’provision of communitybased tuberculosis care for hard-to-reach populations in Myanmar,2013-2014  

作　　者：Kyaw Thu Soe Saw Saw Johan van Griensven Shuisen Zhou Le Win Palanivel Chinnakali Safieh Shah Myo Myo Mon Si Thu Aung 

机构地区：[1]Department of Medical Research,(Pyin Oo Lwin Branch),Ward 16,Near Anisakhan Airport,Pyin Oo Lwin Township,Mandalay Region,Myanmar [2]Institute of Tropical Medicine,Nationalestraat 155,Antwerp 2000,Belgium [3]National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention,207 Ruijin Er Road,Shanghai 200025,People’s Republic of China [4]Jawaharlal Institute of Postgraduate Medical Education and Research,No-1,Vinayagar kovil Street,Kathirkamam,Puducherry605009India [5]Operational Research Unit,Medecins Sans Frontieres,Operational Research Unit,68,rue de Gasperich,Luxembourg City L-1617,Luxembourg [6]National Tuberculosis Programme,Disease Control Unit,Nay Pyi Taw Bed 1000 Hospital,Zabu Kyatthayay road,Zabu Thiri Township,Nay Pyi Taw,Myanmar

出　　处：《Infectious Diseases of Poverty》2017年第1期598-604,共7页贫困所致传染病（英文）

基　　金：This study was funded by the Special Program for Research and Training in Tropical Diseases at the World Health Organization(WHO/TDR)Impact Grant given to two TDR alumni from the DMR;The funders had no role in the study design,data collection and analysis,decision to publish,or preparation of the paper.

摘　　要：Background:National tuberculosis(TB)programs increasingly engage with international non-governmental organizations(INGOs),especially to provide TB care in complex settings where community involvement might be required.In Myanmar,however,there is limited data on how such INGO community-based programs are organized and how effective they are.In this study,we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar,and assess their contribution to TB case detection.Methods:We conducted a descriptive study using program data from four INGOs and the National TB Program(NTP)in 2013-2014.For each INGO,we extracted information on its approach and key activities,the number of presumptive TB cases referred and undergoing TB testing,and the number of patients diagnosed with TB and their treatment outcomes.The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships.Results:All four INGOs implemented community-based TB care in challenging contexts,targeting migrants,post-conflict areas,the urban poor,and other vulnerable populations.Two recruited community volunteers via existing community health volunteers or health structures,one via existing community leaderships,and one directly involved TB infected/affected individuals.Two INGOs compensated volunteers via performance-based financing,and two provided financial and in-kind initiatives.All relied on NTP laboratories for diagnosis and TB drugs,but provided direct observation treatment support and treatment follow-up.A total of 21995 presumptive TB cases were referred for TB diagnosis,with 7383(34%)new TB cases diagnosed and almost all(98%)successfully treated.The four INGOs contributed to the detection of,on average,36%(7383/20663)of the total new TB cases in their respective townships(range:15-52%).Conclusion:Community-based TB care supported by INGOs successfully achieved TB case detec

关 键 词：Operational research Community TUBERCULOSIS VOLUNTEERS Contribution International nongovernmental organizations Myanmar 

分 类 号：R73[医药卫生—肿瘤]