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Type: Journal article
Title: Community based interventions for the prevention and control of tuberculosis
Author: Arshad, A.
Salam, R.
Lassi, Z.
Das, J.
Naqvi, I.
Bhutta, Z.
Citation: Infectious Diseases of Poverty, 2014; 3(1):27-1-27-10
Publisher: BioMed Central
Issue Date: 2014
ISSN: 2049-9957
Statement of
Ahmed Arshad, Rehana A Salam, Zohra S Lassi, Jai K Das, Imama Naqvi, and Zulfiqar A Bhutta
Abstract: In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.
Keywords: CHWs; Community-based interventions; DOTS; Tuberculosis; integrated delivery
Rights: © 2014 Arshad et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
RMID: 0030038050
DOI: 10.1186/2049-9957-3-27
Appears in Collections:Medicine publications

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