Tuberculosis

Projects

A Prototype for Active Tuberculosis Case Finding in Mumbai

Collaborator The Partners in Urban Knowledge Action and Research (PUKAR) Trust

Principal Investigator Dr. Nerges Mistry

Project team Dr. Yatin Dholakia and team from PUKAR

Funder Vasant J Sheth Memorial Foundation

Duration March 2014 - February 2015

Budget Rs. 5 Lakhs

Background

Overcrowding, poor living conditions and poor quality of care, put individuals at high risk for TB and adverse treatment outcomes. Undiagnosed and poorly managed TB patients are likely to drive the TB epidemic in such settings. Several studies have found that the core problem lies in the delay of diagnosis and treatment. The gap between these delays can be filled through actively screening for undiagnosed TB cases and administering the right treatment.

Kaula Bunder, located on a wharf is inhabited by around 12,000 people who have poor access to basic amenities of life as they are a non notified slum. A study of the health indicators in the slum revealed that these were worse than those of other Mumbai slums.

A study to develop a prototype for active Tuberculosis case finding in Mumbai was designed to estimate the hidden load of TB in adults and children, develop a prototype for up-scaling active surveys in the city, develop linkages of slums with TB control program and services and provide opportunity for community education and awareness activities.

Study

This project for active survey for tuberculosis is planned to be conducted in two stages.

In the initial stage, PUKAR would prepare the community for the detailed assessment by sensitizing them and creating awareness about tuberculosis. This was to be done between February and April and repeated again from June onwards. The Foundation for Medical Research would then conduct an active TB case finding survey in the months of September and October after the monsoons.

Volunteers from PUKAR were trained in Tuberculosis at FMR by Dr. Dholakia.  A film on TB has been acquired to be screened in the community. PUKAR’s team has started sensitization and awareness programs in February 2014. During the program a verbal assessment was done by the team as to the knowledge about tuberculosis. Initially, participants were not willing to talk about TB and did not have knowledge about the disease. There were many misconceptions. Following the screening of the TB film and talks by the researchers, the participants started discussions and were open to discussions.

The first phase of the awareness program is completed. A total of 50 programs have been conducted in a systematic manner as described above. 717 adults and 354 children have participated at these programs. At the end of each program participants came forward with their symptoms – 16 suspected cases of TB have been recorded and have been referred to the nearby diagnostic center – Nawab Tank Clinic of the BMC for free diagnosis. Six TB cases had come forward during the program and one case was on treatment at the BMC center.

PUKAR team will commence a house to house awareness program from June 2014. This will be followed by active case finding by FMR team.

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