Open AccessImplementing TB control in a rural, resource-limited setting: the stop-TB Italia project in Senegal
Author(s) -
Mama Moussa Diaw,
Mamoudou Ndiaye,
Niccolò Riccardi,
Riccardo Ungaro,
Riccardo Alagna,
Daniela María Cirillo,
Luigi Codecasa,
Claudio Viscoli,
Laura Ambra Nicolini,
Giorgio Besozzi
Publication year - 2018
Publication title -
multidisciplinary respiratory medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.72
H-Index - 28
eISSN - 2049-6958
pISSN - 1828-695X
DOI - 10.4081/mrm.2018.203
Subject(s) - medicine , tuberculosis , psychological intervention , observational study , sputum , tuberculosis control , health care , surgery , pediatrics , nursing , pathology , economics , economic growth
Background: Since 2013 StopTB Italia Onlus supports the Senegalese National Tuberculosis Programme by improving diagnostic capability with technological interventions, ameliorating educational programs for health care personnel, rising awareness among civil society and providing economical support for patients during treatment. The purpose of our study was to assess the preliminary results of an interventional cooperation project in a peripheral health care facility in Senegal. Methods: An observational, retrospective, pre-post study was conducted to compare Tuberculosis (TB) retention in care and outcome between a one-year period before and a four-year period after. Results: Overall, 239 patients with active TB were included, 196 (82%) of whom after the starting of the collaboration project. At diagnosis 35/43(81.4%) vs 151/196 (77%) patients were smear sputum positive before and after the beginning of the project, respectively. At 2 months follow up 23/35 (65.7%) patients in 2012 vs. 139/151 (92%) patients in 2013–2016 had negative control AFB stain (p = 0.249), 4/35 (11.4%) vs 12/151 (8%) patients remained AFB stain positive (p = 0.17), 7/35 (20%) vs 0/151 died before the 2 months follow up (p < 0.0001). TB treatment outcome was more frequently favourable after the beginning of cooperation 29/43 (67.4%) vs. 176/196 (89.8%) patients, (p < 0.0001). Patients’ mortality during treatment decreased from 8/43 (18.6%) in 2012 to 11/196 (5.6%) patients in the following years (p = 0.009). Conclusion: The implementation of diagnostic procedures, if integrated in a socio-economical intervention, impacts favourably on TB retention in care and treatment outcomes.