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Tb Failure

Decent Essays

There has been renewed interest of late in reaching the 3 million individuals with active TB infection each year who currently fall between the cracks in TB control efforts. There were programmes such as the Stop TB Partnership’s TB REACH initiative have been at the forefront of strategies to identify hard-to-reach populations through the scale-up of ACF for TB. While a body of literature has emerged examining the effectiveness of various ACF approaches, the acceptability of ACF has, to date, received scant attention. Using participation rates as a proxy for acceptability, support for ACF is generally presumed to be high; however, participation rates alone are of limited value in understanding the optimal applications of ACF and informing policy change. Our study is one of the first to systematically explore the perspectives of patients and health providers engaged in community-based ACF. Findings suggest a high level of acceptability for home-based ACF across key stakeholders, including TB patients, village health volunteers, community TB workers, and public sector providers.

For ACF to have an impact on TB control, early case …show more content…

By proactively seeking out patients at risk of TB, rather than passively capturing patients seeking treatment of their own volition, ACF has the benefit of reaching individuals in earlier stages of disease. An indirect consequence of early detection, however, is that individuals may not self-identify as ill and may be reluctant to accept their diagnosis. Since, in general, ACF patients initiate treatment from a healthier baseline, the real and/or perceived discomfort from anti-TB drugs may dwarf the perceived benefits of treatment initiation and adherence. These factors contribute to rates of initial loss to follow-up in ACF as high as 25% potentially undermining the gains made through increased case

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