Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22
Background and Objective: We evaluated the DR-TB component of the National Tuberculosis Elimination Program (NTEP) in a high-burden district in Kerala to identify the programmatic gaps, if any, in screening, diagnosis, treatment, and follow-up of notified DR-TB patients. Methods: A mixed-methods des...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Lung India |
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| Online Access: | https://journals.lww.com/10.4103/lungindia.lungindia_355_24 |
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| author | Raman Swathy Vaman Madhanraj Kalyanasundaram Malu Mohan Narayana Pradeepa Manoj V. Murhekar |
| author_facet | Raman Swathy Vaman Madhanraj Kalyanasundaram Malu Mohan Narayana Pradeepa Manoj V. Murhekar |
| author_sort | Raman Swathy Vaman |
| collection | DOAJ |
| description | Background and Objective:
We evaluated the DR-TB component of the National Tuberculosis Elimination Program (NTEP) in a high-burden district in Kerala to identify the programmatic gaps, if any, in screening, diagnosis, treatment, and follow-up of notified DR-TB patients.
Methods:
A mixed-methods design was used, and the evaluation was performed in two steps. In the first step, we reviewed the program documents and conducted stakeholder interviews to develop a detailed description of the program design and developed a logical framework to evaluate program performance. Consequently, in the next step, we conducted programmatic data reviews, facility surveys, and in-depth interviews with key stakeholders to identify the programmatic gaps in implementation, guided by the logic framework.
Results:
Of the 494 microbiologically confirmed TB patients during 2021-22, 342 (69%) were tested for drug sensitivity, and 30 DR-TB patients were identified. There was no separate district DR-TB treatment center with airborne infection control facilities, and only 16% (66/422) of the various categories of staff were trained in recent guidelines. Only 30% (9/30) of DR-TB patients were provided with any psychological assessment. The favorable treatment outcome was 80% Interviews revealed poor readiness and motivation from the private sector for screening, contextual barriers in human resource availability, transportation, and financial barriers to the beneficiary despite providing financial benefits.
Conclusion:
Prioritizing the establishment of a district DR-TB treatment center and sputum transport mechanism, posting a clinical psychologist dedicated to counseling patients on therapy, and training all categories of staff on DR-TB management guidelines will significantly contribute to improving program outcomes. |
| format | Article |
| id | doaj-art-3a95f14e9f4048da9e246acdd3522fe8 |
| institution | Kabale University |
| issn | 0970-2113 0974-598X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Lung India |
| spelling | doaj-art-3a95f14e9f4048da9e246acdd3522fe82025-01-07T07:38:57ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2025-01-01421162410.4103/lungindia.lungindia_355_24Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22Raman Swathy VamanMadhanraj KalyanasundaramMalu MohanNarayana PradeepaManoj V. MurhekarBackground and Objective: We evaluated the DR-TB component of the National Tuberculosis Elimination Program (NTEP) in a high-burden district in Kerala to identify the programmatic gaps, if any, in screening, diagnosis, treatment, and follow-up of notified DR-TB patients. Methods: A mixed-methods design was used, and the evaluation was performed in two steps. In the first step, we reviewed the program documents and conducted stakeholder interviews to develop a detailed description of the program design and developed a logical framework to evaluate program performance. Consequently, in the next step, we conducted programmatic data reviews, facility surveys, and in-depth interviews with key stakeholders to identify the programmatic gaps in implementation, guided by the logic framework. Results: Of the 494 microbiologically confirmed TB patients during 2021-22, 342 (69%) were tested for drug sensitivity, and 30 DR-TB patients were identified. There was no separate district DR-TB treatment center with airborne infection control facilities, and only 16% (66/422) of the various categories of staff were trained in recent guidelines. Only 30% (9/30) of DR-TB patients were provided with any psychological assessment. The favorable treatment outcome was 80% Interviews revealed poor readiness and motivation from the private sector for screening, contextual barriers in human resource availability, transportation, and financial barriers to the beneficiary despite providing financial benefits. Conclusion: Prioritizing the establishment of a district DR-TB treatment center and sputum transport mechanism, posting a clinical psychologist dedicated to counseling patients on therapy, and training all categories of staff on DR-TB management guidelines will significantly contribute to improving program outcomes.https://journals.lww.com/10.4103/lungindia.lungindia_355_24indialogic framework modelmultidrug-resistant tuberculosisprogram evaluation |
| spellingShingle | Raman Swathy Vaman Madhanraj Kalyanasundaram Malu Mohan Narayana Pradeepa Manoj V. Murhekar Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22 Lung India india logic framework model multidrug-resistant tuberculosis program evaluation |
| title | Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22 |
| title_full | Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22 |
| title_fullStr | Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22 |
| title_full_unstemmed | Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22 |
| title_short | Evaluation of the Drug-Resistant Tuberculosis (DR-TB) management component under the National Tuberculosis Elimination Program (NTEP) in Kerala, India, 2021-22 |
| title_sort | evaluation of the drug resistant tuberculosis dr tb management component under the national tuberculosis elimination program ntep in kerala india 2021 22 |
| topic | india logic framework model multidrug-resistant tuberculosis program evaluation |
| url | https://journals.lww.com/10.4103/lungindia.lungindia_355_24 |
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