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Kandasamy G, Almaghaslah D, Almanasef M. Knowledge, attitude and practice towards tuberculosis among healthcare and non-healthcare students at a public university in Saudi Arabia. Front Public Health 2024; 12:1348975. [PMID: 38379677 PMCID: PMC10877943 DOI: 10.3389/fpubh.2024.1348975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
Background Tuberculosis (TB) is a bacterial infection. It mostly affects the lungs (pulmonary TB), but it can also affect other organs. This cross-sectional study evaluated knowledge, attitudes, and practices (KAP) related to TB among King Khalid University (KKU) students between October and November 2023. Objective The objective of this study was to investigate current TB knowledge, attitudes, and practices of students at King Khalid University in Abha, Saudi Arabia. Methods A self-administered, cross-sectional, descriptive, web-based questionnaire was conducted from October to December 2023 among the students of King Khalid University. We used a 29-item questionnaire with five sections. Section 1 contained five questions about sociodemographic factors, there were 13 knowledge questions in Section 2, Section 3 contained 7 attitude questions, Section 4 contained 3 practice questions, and Section 5 contained 1 source of information question. A chi-squared test was used to assess differences in participants' knowledge, attitude, and practices in relation to their demographic variables (p < 0.05). Results A total of 518 students completed the questionnaire. 53.66% were healthcare students and 46.33% non-healthcare students. The mean scores for healthcare and non-healthcare students, respectively, were as follows: knowledge 11.80 ± 4.81, 7.35 ± 4.96; attitude 6.94 ± 1.33, 5.05 ± 2.09; and practice 2.26 ± 0.85, 1.14 ± 0.87. The results of this study showed good knowledge (24.82 and 5.83% for healthcare and non-healthcare students, respectively) good attitude (67.62 and 46.25%) and good practice (45.32 and 9.58%). A total of 24.32% healthcare students and 28.18% non-healthcare students reported that most effective sources for obtaining information about TB were social networks, the internet and the radio. Conclusion The current study concludes that the knowledge, attitude, and practice about TB among healthcare faculty students is better than their non-healthcare counterparts. However, there are still areas of poor knowledge, attitude and practice toward some aspects of TB among the two categories, which shows the necessity of educational intervention that aims at improving student understanding about the disease and its impact on public health.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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Sekandi JN, Quach T, Olum R, Nakkonde D, Farist L, Obiekwe R, Zalwango S, Buregyeya E. Stigma and Associated Sex Disparities Among Patients with Tuberculosis in Uganda: A Cross-Sectional Study. RESEARCH SQUARE 2024:rs.3.rs-3794900. [PMID: 38260614 PMCID: PMC10802719 DOI: 10.21203/rs.3.rs-3794900/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background Tuberculosis (TB) is one of the leading causes of death from a single infectious agent globally. Stigma associated with TB encompassing self-, anticipated-, and public-stigma has significant negative effects on treatment adherence. In Uganda, limited data exist on the prevalence of stigma and its relationship with sex among patients with TB. We evaluate prevalence of three types of stigma and their relationship with the sex of patients undergoing TB treatment. Methods This cross-sectional study was conducted between July 2020 to March 2021 at selected TB clinics in Kampala, Uganda. Eligible participants were aged 18-65 with confirmed TB and starting their prescribed treatment. We collected data on socio-demographics and used 13 items to capture the self-, anticipated-, and public-stigma from which we composed the dependent variables. The primary independent variable was sex. We employed multivariable logistic regression analysis to evaluate the association between sex and the three stigma types. Additionally, we considered potential confounders such as age, HIV, and employment status. Statistical significance was defined as p<0.05. Results In this study we enrolled 144 participants with a mean age of 35.8 years (standard deviation = 12). Half of the participants (50%, n=72) were female, 44% had a secondary education, 37.5% were unemployed, and 32.6% were co-infected with HIV. The prevalence of self-stigma was 71.1%, anticipated stigma was 75.7%, and public stigma was 41.7%. Significant factors were associated with self-stigma were female sex (adjusted odds ratio (AOR): 2.35 95% CI: 1.02-5.74) and unemployment (AOR: 2.95 95% CI: 1.16-8.58). HIV-positive status was significantly associated with anticipated stigma (AOR: 3.58 95% CI: 1.38-11.23). However, none of the variables we evaluated showed a significant association with public stigma. Conclusions Our study showed a high prevalence of self, anticipated and public stigma among TB patients. Notably, females and unemployed individuals were at a higher risk of self-stigma, while those with HIV/AIDS and TB were more likely to report anticipated stigma. To combat stigma effectively, interventions should be tailored to cater to sex-specific needs and persons living with HIV. Future research should delve further in determinants of TB-related stigma in high-burden settings.
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Affiliation(s)
- Juliet N Sekandi
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Trang Quach
- Global Health Institute, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Ronald Olum
- Makerere University School of Public Health, Kampala, Uganda
| | | | - Leila Farist
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Rochelle Obiekwe
- Global Health Institute, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Sarah Zalwango
- Kampala Capital City Authority, Department of Public Health Service and Environment, Kampala, Uganda
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Mainga T, Gondwe M, Mactaggart I, Stewart RC, Shanaube K, Ayles H, Bond V. Qualitative study of patient experiences of mental distress during TB investigation and treatment in Zambia. BMC Psychol 2022; 10:179. [PMID: 35854324 PMCID: PMC9295264 DOI: 10.1186/s40359-022-00881-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/05/2022] [Indexed: 11/24/2022] Open
Abstract
Background The mental health and TB syndemic is a topic that remains under-researched with a significant gap in acknowledging and recognizing patient experiences, particularly in the sub-Saharan African region. In this qualitative study conducted in Zambia, we aimed to explore the lived mental health experiences of TB patients focusing on their multi-layered drivers of distress, and by so doing highlighting contextual factors that influence mental distress in TB patients in this setting.
Methods The study draws on qualitative data collected in 2018 as part of the Tuberculosis Reduction through Expanded Antiretroviral Treatment and Screening for active TB trial (TREATS) being conducted in Zambia. The data was collected through in-depth interviews with former TB patients (n = 80) from 8 urban communities participating in the TREATS trial. Thematic analysis was conducted. Additional quantitative exploratory analysis mapping mental distress symptoms on demographic, social, economic and TB characteristics of participants was conducted.
Results Most participants (76%) shared that they had experienced some form of mental distress during their TB investigation and treatment period. The reported symptoms ranged in severity. Some participants reported mild distress that did not disrupt their daily lives or ability to adhere to their TB medication, while other participants reported more severe symptoms of distress, for example, 15% of participants shared that they had suicidal ideation and thoughts of self-harm during their time on treatment. Mental distress was driven by unique interactions between individual, social and health level factors most of which were inextricably linked to poverty. Mental distress caused by individual level drivers such as TB morbidity often abated once participants started feeling better, however social, economic and health system level drivers of distress persisted during and beyond TB treatment. Conclusion The findings illustrate that mental distress during TB is driven by multi-layered and intersecting stresses, with the economic stress of poverty often being the most powerful driver. Measures are urgently needed to support TB patients during the investigation and treatment phase, including increased availability of mental health services, better social security safety nets during TB treatment, and interventions targeting TB, HIV and mental health stigma. Trial registration ClinicalTrials.gov NCT03739736. Trial registration date: November 14, 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00881-x.
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Affiliation(s)
- T Mainga
- Zambart, University of Zambia School of Public Health, Ridgeway, Zambia. .,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
| | - M Gondwe
- Zambart, University of Zambia School of Public Health, Ridgeway, Zambia
| | - I Mactaggart
- Department of Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - R C Stewart
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK.,Malawi Epidemiology and Intervention Research Unit (MEIRU), Lilongwe, Malawi
| | - K Shanaube
- Zambart, University of Zambia School of Public Health, Ridgeway, Zambia
| | - H Ayles
- Zambart, University of Zambia School of Public Health, Ridgeway, Zambia.,Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - V Bond
- Zambart, University of Zambia School of Public Health, Ridgeway, Zambia.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Garg T, Panibatla V, Carel JP, Shanta A, Bhardwaj M, Brouwer M. Can Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation Research from India. Trop Med Infect Dis 2021; 6:tropicalmed6040200. [PMID: 34842840 PMCID: PMC8628981 DOI: 10.3390/tropicalmed6040200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/22/2022] Open
Abstract
Navigating the Indian health system is a challenge for people with tuberculosis (TB) symptoms. The onus of organizing care is on the patient and their families alone. Factors like gender discrimination and opportunity costs further aggravate this. As a result, people may not complete the diagnostic and treatment pathway even though they experience poor health. Navigators can aid in the pathway’s completion. We implemented two projects in India—a public sector intervention in Bihar, with a population of 1.02 million, and a private sector intervention in Andhra Pradesh (AP), with a population of 8.45 million. Accredited Social Health Activists (ASHAs) of the public health system in Bihar and local field officers in AP facilitated the patients’ navigation through the health system. In Bihar, ASHAs accompanied community-identified presumptive TB patients to the nearest primary health center, assisted them through the diagnostic process, and supported the patients throughout the TB treatment. In AP, the field officers liaised with the private physicians, accompanied presumptive patients through the diagnosis, counseled and started treatment, and followed-up with the patients during the treatment. Both projects recorded case-based data for all of the patients, and used the yield and historical TB notifications to evaluate the intervention’s effect. Between July 2017 and December 2018, Bihar confirmed 1650 patients, which represented an increase of 94% in public notifications compared to the baseline. About 97% of them started treatment. During the same period in AP, private notifications increased by 147% compared to the baseline, and all 5765 patients started treatment. Patient navigators support the patients in the diagnostic and treatment pathways, and improve their health system experience. This novel approach of involving navigators in TB projects can improve the completion of the care cascade and reduce the loss to follow-up at various stages.
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Affiliation(s)
- Tushar Garg
- Innovators In Health, Patna 800001, India;
- Correspondence:
| | | | - Joseph P. Carel
- Independent Consultant, New Delhi 110001, India; (J.P.C.); (A.S.)
| | - Achanta Shanta
- Independent Consultant, New Delhi 110001, India; (J.P.C.); (A.S.)
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Lin B, Zhong G, Liang Z, Huang J, Wang X, Lin Y. Perceived-stigma level of COVID-19 patients in China in the early stage of the epidemic: A cross-sectional research. PLoS One 2021; 16:e0258042. [PMID: 34597354 PMCID: PMC8486130 DOI: 10.1371/journal.pone.0258042] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 09/16/2021] [Indexed: 12/30/2022] Open
Abstract
Objective To investigate the perceived-stigma level of COVID-19 patients in the early stage of the epidemic and analysed related factors and correlations that affected the stigma levels. Methods The COVID-19 patients were selected using the convenience sampling method. Perceived-stigma level was evaluated using the Social Impact Scale (SIS). Frequency was used to describe the general information and disease investigation status of COVID-19 patients; mean and standard deviation were used for describing stigma levels, Wilcoxon signed-ranks test (nonparametric test) was applied for pairwise comparison. Kruskal-Wallis non-parametric test for grade data, and Dwass-Steel-Critchlow-Fligner test for multiple comparative analysis. Multiple linear regression analysis was performed, and statistically significant indicators in single-factor analysis were included to investigate the independent factors of stigma. The p<0.05 was considered statistically significant. Results SIS score of the 122 COVID-19 patients averaged 57.37±9.99 points. There were statistically significant differences in perceived-stigma levels among patients of different ages (p = 0.008), occupation (p <0.001), marital status (p = 0.009), and disease severity (p = 0.020). Multivariate logistic regression analysis revealed that age was the main influencing factor of stigma (p<0.05). Conclusions The overall perceived-stigma level of COVID-19 patients in the early stage of the epidemic was moderate. Younger, unmarried, and severely ill patients had a higher level of perceived-stigma, with age being the main factor. More attention should be given to the young COVID-19 patients.
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Affiliation(s)
- Bihua Lin
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Guiqin Zhong
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zeyan Liang
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jianying Huang
- Department of Critical Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaofang Wang
- Department of Disinfection Supply Centre, Pingtan Branch of Fujian Medical University Union Hospital, Fuzhou, China
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
- * E-mail:
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Jiang T, Zhou X, Lin L, Pan Y, Zhong Y, Wang X, Zhu H. COVID-19-related stigma and its influencing factors: a nationwide cross-sectional study during the early stage of the pandemic in China. BMJ Open 2021; 11:e048983. [PMID: 34389575 PMCID: PMC8366283 DOI: 10.1136/bmjopen-2021-048983] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To describe the situation of COVID-19-related stigma towards patients with COVID-19 and people from the city of Wuhan in China and to assess the associations between COVID-19-related stigma, health literacy and sociodemographic characteristics during March 2020, the early stage of the pandemic. DESIGN A cross-sectional online survey. SETTING The study surveyed 31 provinces in China. PARTICIPANTS This study surveyed 5039 respondents in China. OUTCOME MEASURES Public stigma towards both patients with COVID-19 and Wuhan residents was measured. Binary logistic regression was used to identify the factors associated with public COVID-19-related stigma. RESULTS Among the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in as holding a stigmatising attitude towards patients with COVID-19, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, which was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (adjusted OR (aOR)=2.03, 95% CI (1.05 to 3.92)) and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI (1.08 to 3.37); aOR=1.88, 95% CI (1.08 to 3.29)) were more likely to stigmatise patients with COVID-19. People who were male, aged 41-50 and had difficulty understanding information (aOR=2.08, 95% CI (1.17 to 3.69)) were more likely to stigmatise people from Wuhan. CONCLUSIONS Patients with COVID-19 and Wuhan residents suffered stigma at both the individual and the community levels. Those who had low health literacy, who lived in areas with a large number of COVID-19 cases and who were of ethnic minorities were more likely to stigmatise others. Tailored interventions are encouraged to improve health literacy and consequently to reduce public COVID-19-related stigma.
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Affiliation(s)
- Tianyu Jiang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Leesa Lin
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, SAR, China
| | - Yanzheng Pan
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuyuan Zhong
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaomin Wang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hui Zhu
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
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Kundu S, Basu R, Sarkar S, Nath S, Biswas D. Psychological profile of multi drug resistance TB patients: A qualitative study from a Tertiary care Centre of Kolkata. J Family Med Prim Care 2021; 10:392-397. [PMID: 34017759 PMCID: PMC8132840 DOI: 10.4103/jfmpc.jfmpc_1787_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/25/2020] [Accepted: 11/24/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION There has been a new challenge to the already existing threat of tuberculosis (TB) and that is drug resistance TB (DR-TB). The causal relationships between mental disorders and TB are complicated and relatively unexplored. For this reason a qualitative study was done on DR-TB patients attending R G Kar Medical College. MATERIALS AND METHODS The study population consisted of the patients who are registered for the DR-TB regimen are followed up four times with General Health Questionnaire (GHQ). Those scoring poorly were sent for expert evaluation by psychologist, who counselled them, and followed them up after in-depth interviews. These records of in-depth interview were analysed as qualitative research inputs. RESULTS In our study out of 165 patients, (4.8%) needed interventions. The domains emerging from the study are worried about future and as well as family, disbelief about the diagnosis, embarrassment regarding the diagnosis, fear of death, blaming fate for the disease, stigma, suicidal ideation. CONCLUSION This study finds out the important domains of psychogical problems among the patients and also advocates a psychologist to remain at DR-TB centres.
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Affiliation(s)
- Susmita Kundu
- Professor and Head of Department, Respiratory Medicine, R G Kar Medical College, Kolkata, India
| | - Rivu Basu
- Assistant Professor, Community Medicine, R G Kar Medical College, Kolkata, India
| | | | - Saswati Nath
- Associate Professor, Psychiatry, Respiratory Medicine, R G Kar Medical College, Kolkata, India
| | - Debabani Biswas
- Associate Professor, Respiratory Medicine, R G Kar Medical College, Kolkata, India
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Mohammedhussein M, Hajure M, Shifa JE, Hassen TA. Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: A cross-sectional study. PLoS One 2020; 15:e0243433. [PMID: 33290413 PMCID: PMC7731994 DOI: 10.1371/journal.pone.0243433] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/21/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Although tuberculosis (TB) related stigma has a significant impact on the diagnosis, patient adherence with treatment, and recovery from the disease, there is limited evidence from Ethiopia regarding perceived stigma among patient with pulmonary tuberculosis (PTB).The purpose of this study was to assess perceived stigma and associated factors among patient with PTB on treatment in southwest Ethiopia. METHODS Institution-based cross-sectional study was conducted from April to May 2019 among 410 patient with PTB. Data were collected by using the perceived tuberculosis stigma scale. Epi data v3.1 and SPSSv23 were used for data entry and analysis. Multivariable logistic regression models were fitted to identify factors associated with perceived stigma. Results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). RESULT Prevalence of perceived stigma among patient with Pulmonary tuberculosis was 57.1% (95% CI: 52.2, 61.7). Poor social support (AOR = 2.41; 95% CI: 1.06, 5.48), above a month duration of illness (AOR = 2.48; 95% CI: 1.33, 4.64), high perceived stress (AOR = 1.95; 95% CI:1.09, 3.49), current khat use (AOR = 1.88; 95% CI:1.05, 3.37), and presence of depression (AOR = 8.18; 95% CI:4.40, 15.22) were significantly associated with perceived stigma. Patient with HIV co-infection were 5.67 times (AOR = 5.67; 95% CI: 2.32, 13.87) more likely to have Perceived stigma than their counterparts. CONCLUSION TB related stigma was reported by more than half of the study participant. Stigma reduction measures are needed to lower TB related stigma perceived by the patient, the level of distress associated with it, and to promote the psychological wellbeing of patient with TB.
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Affiliation(s)
- Mustefa Mohammedhussein
- Department of Psychiatry, Faculty of Public Health and Medical Sciences, Mettu University, Mettu, Ethiopia
| | - Mohammedamin Hajure
- Department of Psychiatry, Faculty of Public Health and Medical Sciences, Mettu University, Mettu, Ethiopia
| | - Jemal Ebrahim Shifa
- Department of Psychiatry, School of Health Sciences, Mada Walabu University, Shashemene campus, Shashemene, Ethiopia
| | - Tahir Ahmed Hassen
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Biswas B, Kumar A, Agarwal N. Performance of revised national tuberculosis control program in Bihar: A situational analysis. J Family Med Prim Care 2020; 9:735-739. [PMID: 32318411 PMCID: PMC7113949 DOI: 10.4103/jfmpc.jfmpc_1028_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/13/2020] [Accepted: 01/24/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Monitoring of a program is a continuous assessment of certain key indicators of it through periodic reports. The efficiency of a health program is assessed by comparing its achievements with the expectations. Methods: The study was conducted based on the annual TB report of India for the year 2018 in order to monitor (Revised National Tuberculosis Control Program) RNTCP performance in the Bihar State and its various districts. Results: Case notification rate of various districts Bihar was far below the national average of 138 per lakh. Considering treatment initiation, the performance of various districts of Bihar were less than national figures (79.0%). In newly diagnosed TB cases, the treatment success rate of Bihar was 73%. This performance was more compared to Uttar Pradesh (66.0%) but less compared to Jharkhand (92.0%), West Bengal (88.0%), and national data (79.5%). Considering human resources, the total human resources in the states of Bihar (61.9%) and Jharkhand (58.3%) were similar. However, in Bihar, there was a vast shortage of ground-level staff [i.e. (senior treatment supervisor) STS, (senior TB lab supervisor) STLS, (public-private mix) PPM Co-ordinator, and (TB health visitor) TBHV)]. Conclusion: It was found that Bihar was one of the less performing states in RNTCP with a vast shortage of ground-level staff and low overall treatment success rate compared to its neighboring states. Stringent monitoring and evaluation in every step of the program implementation should be done in order to improve RNTCP performance in Bihar.
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Affiliation(s)
- Bijit Biswas
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Abhishek Kumar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Neeraj Agarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
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