02038nas a2200253   4500000000100000008004100001653001700042653002400059653000900083653003400092653000900126100001300135700001200148700001200160700001000172700001200182700001300194245008200207856007900289300000700368490000600375520138900381022001401770       2014                            d10aTuberculosis10aintegrated delivery10aDots10aCommunity-based interventions10aCHWs1 aArshad A1 aSalam R1 aLassi Z1 aDas J1 aNaqvi I1 aBhutta Z00aCommunity based interventions for the prevention and control of tuberculosis.  uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4136404/pdf/2049-9957-3-27.pdf  a270 v33 a<p>In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.</p>  a2049-9957