How to support a tuberculosis program in active contact tracing- A case study from Pakistan

 

How to support a tuberculosis program in active contact tracing- A case study from Pakistan

Tuberculosis Treatment

 In Pakistan, the prevalence of tuberculosis (TB) is increasing for a variety of reasons, such as poverty, difficulty in accessing TB treatment services, non-compliance with treatment, societal stigma, etc. The absence of qualified human resources and the scarcity of tuberculosis treatment and testing facilities, according to the TB program administrators, are two main factors that compromise TB management. The lack of an active contact tracing technique is a significant gap in the TB control effort. This is crucial for a condition because it is known that positive patients can spread the infection to an additional 10–15 people in a year.

Despite having one of the highest disease burdens in the world, Pakistan has struggled to combat tuberculosis due to budget issues and other systemic impediments like a lack of competent human resources and an inadequate supply of medicines. Despite the fact that the disease must be reported, active case finding, contact tracing, and reporting are infamously low across the nation. The stigma associated with the condition is still very well-entrenched in the communities, and access to diagnostic and treatment services has been restricted. According to research, more patients with TB can be effectively identified among home contacts by using upgraded and active contact inquiry methods, which are also reasonably inexpensive.

Support was provided to the health departments of the provinces of Sindh and Khyber Pakhtunkhwa through USAID's Integrated Health Systems Strengthening and Service Delivery Activity. Based on the index cases, community-based active contact tracing was carried out on 17,696 people in cooperation with the two provincial TB programs. Among the contacts identified, 243 cases of drug-sensitive or drug-resistant TB were identified. To make individuals aware of the various facets of sickness and the significance of getting checked, awareness programs were held.

In order to improve the programs' capacity for diagnostic and testing, the project also funded the establishment of three satellite Programmatic Management of Drug-Resistant Tuberculosis (PMDT) centers for drug-resistant TB treatment.

CONCLUSION:

With sufficient funding and other resource inputs, screening of the household and other close social contacts of DS and DR-TB index cases may be seriously considered as a permanent part of the TB control program in Pakistan. This strategy has not only stopped DS TB cases from becoming DR TB cases, but it has also prevented the high cost of treating DR TB cases compared to treating DS TB cases. The amount of presumptive TB contacts that needed to be tested as part of the IHSS-SD Activity's intervention to find a new case of DR-TB indicates an effective approach that could be easily scaled up. When working together to eradicate TB in Pakistan, a top focus should be given to screening and treating vulnerable individuals and even children who live with TB patients.