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Lessons Learned From a Peer-Supported Differentiated Care and Nutritional Supplementation for People With TB in a Southern Indian State.
Shewade, Hemant Deepak; Jaisingh, A James Jeyakumar; Ravichandran, Prabhadevi; Pradeep, S Kiran; Pandurangan, Sripriya; Mohanty, Subrat; Rajasekar, T Daniel; Vijayaprabha, R; Kiruthika, G; Suma, K V; Pathinathan, Delphina Peter; Chidambaram, Deiveegan; Sivagami, K; Srinivasan, Anupama; Swamickan, Reuben; Goswami, Amrita; Sivaranjani, D; Ananthakrishnan, Ramya; Frederick, Asha; Murhekar, Manoj V.
Afiliação
  • Shewade HD; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India. hemantjipmer@gmail.com.
  • Jaisingh AJJ; REACH (Resource Group for Education and Advocacy for Community Health), Chennai, India.
  • Ravichandran P; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
  • Pradeep SK; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
  • Pandurangan S; REACH (Resource Group for Education and Advocacy for Community Health), Chennai, India.
  • Mohanty S; REACH (Resource Group for Education and Advocacy for Community Health), Chennai, India.
  • Rajasekar TD; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
  • Vijayaprabha R; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
  • Kiruthika G; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
  • Suma KV; Office of the World Health Organization (WHO) Representative to India, WHO Country Office, New Delhi, India.
  • Pathinathan DP; Office of the World Health Organization (WHO) Representative to India, WHO Country Office, New Delhi, India.
  • Chidambaram D; Office of the World Health Organization (WHO) Representative to India, WHO Country Office, New Delhi, India.
  • Sivagami K; Office of the World Health Organization (WHO) Representative to India, WHO Country Office, New Delhi, India.
  • Srinivasan A; REACH (Resource Group for Education and Advocacy for Community Health), Chennai, India.
  • Swamickan R; U.S. Agency for International Development, New Delhi, India.
  • Goswami A; U.S. Agency for International Development, New Delhi, India.
  • Sivaranjani D; TB Free Tamil Nadu Survivors led Network, Krishnagiri, India.
  • Ananthakrishnan R; REACH (Resource Group for Education and Advocacy for Community Health), Chennai, India.
  • Frederick A; State TB Cell, Government of Tamil Nadu, Chennai, India.
  • Murhekar MV; ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai, India.
Article em En | MEDLINE | ID: mdl-39019584
ABSTRACT
Two critical components of patient support systems for people with TB are regular counseling and locally managed nutritional support. As part of an ongoing differentiated TB care initiative called Tamil Nadu Kasanoi Erappila Thittam (meaning TB death-free initiative in Tamil, TN-KET) to reduce TB deaths, adults with TB with very severe undernutrition, respiratory insufficiency, or poor performance status are identified at diagnosis (triage-positive) and prioritized for referral, comprehensive clinical assessment, and inpatient care. Between January and June 2023, in 6 districts, a pilot exercise was conducted in which trained TB survivors, known as TB champions, provided baseline counseling and additional counseling (if required) to triage-positive people with TB at diagnosis. Additionally, people with TB with severe undernutrition were prioritized for nutritional supplementation for at least 3 months. Among 652 people with TB who were triage-positive at diagnosis, the program staff shared details of 145 (22%), and all were counseled by TB champions (baseline counseling). Program staff identified 74 (11%) triage-positive people with TB who required additional counseling (i.e., those refusing referral or admission or continued admission), and 71 (96%) were counseled by TB champions. Among these, 54 (76%) were admitted or readmitted and successfully discharged. In addition, among 1,042 people with TB with severe undernutrition, program staff shared details of 390 (38%), of which 60% received nutritional supplementation through the efforts of TB champions. We conclude that TB champions were able to provide quality and timely peer support through direct counseling and by mobilizing local resources for nutritional support. The engagement of TB champions can be further strengthened by establishing robust coordination mechanisms with the TB program. Lessons from this pilot will contribute to the Tamil Nadu State TB Cell's plans to expand the role of TB champions and enhance community participation to end TB in India.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Glob Health Sci Pract Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Índia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Glob Health Sci Pract Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Índia