Fifth year of a public-private partnership to improve the case detection of tuberculosis in India: A role model for future action?

David Ford, Bornali Datta, Ashish Kumar Prakash, Jaya Prasad Tripathy, Pinky Goyal, Shreya Singh, Anand Jaiswal, Naresh Trehan

Research output: Contribution to journalArticle

Abstract

Background: There is limited access to radiology facilities in most parts of India leading to significant under diagnosis and underreporting of smear negative clinically diagnosed tuberculosis (CDTB). Public Private Partnership (PPP) has a lot to contribute towards addressing this gap through providing access to chest x-ray (CXR) in far-off locations. Method: Mobile vans equipped with digital CXR equipment and support staff were provided by a Corporate Hospital working closely with government, with scheduled visits to government peripheral health institutes. Patients received upfront CXR and sputum microscopy along with GeneXpert in accordance with the revised TB diagnostic algorithm prescribed by the national program, Following a successful pilot in 2014 in district Rewari, “TB free Haryana” was launched in November 2015 with a phased roll out in 16 districts by 2018. Results: The pilot initiative in 2014 confirmed practical and clinical feasibility and revealed a high rate (30% of people screened) of CDTB i.e. symptomatic cases with radiologic abnormalities compatible with Pulmonary TB. In the first year (2016), 5 districts were covered and a total of 3340 CXRs were carried out. There was an increase in the case notification rates of new CDTB (smear negative) in 2016 compared to 2015 (p = 0.036); yielding an additional 180 cases and an 11.67% increase in case detection. Scale up to a total of 13 and 16 districts took place successfully in 2017 and 2018 respectively; with 6268 CXRs and 8021 CXRs done in the respective years. Conclusion: PPP can involve Corporate Hospitals to improve the existing diagnostic infrastructure and provides access to CXR in a not-for-profit sustainable collaboration, with scale-up to the state level; and potential to replicate this initiative in other states.

Original languageEnglish
JournalIndian Journal of Tuberculosis
DOIs
Publication statusAccepted/In press - 01-01-2019
Externally publishedYes

Fingerprint

Public-Private Sector Partnerships
India
Tuberculosis
Thorax
X-Rays
Sputum
Radiology
Microscopy
Equipment and Supplies
Lung
Health

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

Cite this

Ford, David ; Datta, Bornali ; Prakash, Ashish Kumar ; Tripathy, Jaya Prasad ; Goyal, Pinky ; Singh, Shreya ; Jaiswal, Anand ; Trehan, Naresh. / Fifth year of a public-private partnership to improve the case detection of tuberculosis in India : A role model for future action?. In: Indian Journal of Tuberculosis. 2019.
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title = "Fifth year of a public-private partnership to improve the case detection of tuberculosis in India: A role model for future action?",
abstract = "Background: There is limited access to radiology facilities in most parts of India leading to significant under diagnosis and underreporting of smear negative clinically diagnosed tuberculosis (CDTB). Public Private Partnership (PPP) has a lot to contribute towards addressing this gap through providing access to chest x-ray (CXR) in far-off locations. Method: Mobile vans equipped with digital CXR equipment and support staff were provided by a Corporate Hospital working closely with government, with scheduled visits to government peripheral health institutes. Patients received upfront CXR and sputum microscopy along with GeneXpert in accordance with the revised TB diagnostic algorithm prescribed by the national program, Following a successful pilot in 2014 in district Rewari, “TB free Haryana” was launched in November 2015 with a phased roll out in 16 districts by 2018. Results: The pilot initiative in 2014 confirmed practical and clinical feasibility and revealed a high rate (30{\%} of people screened) of CDTB i.e. symptomatic cases with radiologic abnormalities compatible with Pulmonary TB. In the first year (2016), 5 districts were covered and a total of 3340 CXRs were carried out. There was an increase in the case notification rates of new CDTB (smear negative) in 2016 compared to 2015 (p = 0.036); yielding an additional 180 cases and an 11.67{\%} increase in case detection. Scale up to a total of 13 and 16 districts took place successfully in 2017 and 2018 respectively; with 6268 CXRs and 8021 CXRs done in the respective years. Conclusion: PPP can involve Corporate Hospitals to improve the existing diagnostic infrastructure and provides access to CXR in a not-for-profit sustainable collaboration, with scale-up to the state level; and potential to replicate this initiative in other states.",
author = "David Ford and Bornali Datta and Prakash, {Ashish Kumar} and Tripathy, {Jaya Prasad} and Pinky Goyal and Shreya Singh and Anand Jaiswal and Naresh Trehan",
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Fifth year of a public-private partnership to improve the case detection of tuberculosis in India : A role model for future action? / Ford, David; Datta, Bornali; Prakash, Ashish Kumar; Tripathy, Jaya Prasad; Goyal, Pinky; Singh, Shreya; Jaiswal, Anand; Trehan, Naresh.

In: Indian Journal of Tuberculosis, 01.01.2019.

Research output: Contribution to journalArticle

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T1 - Fifth year of a public-private partnership to improve the case detection of tuberculosis in India

T2 - A role model for future action?

AU - Ford, David

AU - Datta, Bornali

AU - Prakash, Ashish Kumar

AU - Tripathy, Jaya Prasad

AU - Goyal, Pinky

AU - Singh, Shreya

AU - Jaiswal, Anand

AU - Trehan, Naresh

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: There is limited access to radiology facilities in most parts of India leading to significant under diagnosis and underreporting of smear negative clinically diagnosed tuberculosis (CDTB). Public Private Partnership (PPP) has a lot to contribute towards addressing this gap through providing access to chest x-ray (CXR) in far-off locations. Method: Mobile vans equipped with digital CXR equipment and support staff were provided by a Corporate Hospital working closely with government, with scheduled visits to government peripheral health institutes. Patients received upfront CXR and sputum microscopy along with GeneXpert in accordance with the revised TB diagnostic algorithm prescribed by the national program, Following a successful pilot in 2014 in district Rewari, “TB free Haryana” was launched in November 2015 with a phased roll out in 16 districts by 2018. Results: The pilot initiative in 2014 confirmed practical and clinical feasibility and revealed a high rate (30% of people screened) of CDTB i.e. symptomatic cases with radiologic abnormalities compatible with Pulmonary TB. In the first year (2016), 5 districts were covered and a total of 3340 CXRs were carried out. There was an increase in the case notification rates of new CDTB (smear negative) in 2016 compared to 2015 (p = 0.036); yielding an additional 180 cases and an 11.67% increase in case detection. Scale up to a total of 13 and 16 districts took place successfully in 2017 and 2018 respectively; with 6268 CXRs and 8021 CXRs done in the respective years. Conclusion: PPP can involve Corporate Hospitals to improve the existing diagnostic infrastructure and provides access to CXR in a not-for-profit sustainable collaboration, with scale-up to the state level; and potential to replicate this initiative in other states.

AB - Background: There is limited access to radiology facilities in most parts of India leading to significant under diagnosis and underreporting of smear negative clinically diagnosed tuberculosis (CDTB). Public Private Partnership (PPP) has a lot to contribute towards addressing this gap through providing access to chest x-ray (CXR) in far-off locations. Method: Mobile vans equipped with digital CXR equipment and support staff were provided by a Corporate Hospital working closely with government, with scheduled visits to government peripheral health institutes. Patients received upfront CXR and sputum microscopy along with GeneXpert in accordance with the revised TB diagnostic algorithm prescribed by the national program, Following a successful pilot in 2014 in district Rewari, “TB free Haryana” was launched in November 2015 with a phased roll out in 16 districts by 2018. Results: The pilot initiative in 2014 confirmed practical and clinical feasibility and revealed a high rate (30% of people screened) of CDTB i.e. symptomatic cases with radiologic abnormalities compatible with Pulmonary TB. In the first year (2016), 5 districts were covered and a total of 3340 CXRs were carried out. There was an increase in the case notification rates of new CDTB (smear negative) in 2016 compared to 2015 (p = 0.036); yielding an additional 180 cases and an 11.67% increase in case detection. Scale up to a total of 13 and 16 districts took place successfully in 2017 and 2018 respectively; with 6268 CXRs and 8021 CXRs done in the respective years. Conclusion: PPP can involve Corporate Hospitals to improve the existing diagnostic infrastructure and provides access to CXR in a not-for-profit sustainable collaboration, with scale-up to the state level; and potential to replicate this initiative in other states.

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