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Search Results: 1 - 10 of 14103 matches for " Sarabjit Singh Chadha "
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Adding Sputum Collection and Transportation Services for Early Identification TB Cases in Hard-to-Reach Difficult Terrain—Will It Help?  [PDF]
Badri Thapa, Banuru Muralidhara Prasad, Sarabjit Singh Chadha, Subrat Mohanty, Deepak R. Mishra, Jamie Tonsing
Journal of Tuberculosis Research (JTR) , 2017, DOI: 10.4236/jtr.2017.54023
Abstract: A community engagement project was designed and implemented to reach 10.6 million population in 13 districts of Uttarakhand state—India, to identify presumptive TB patients (PTBPs) and link to free diagnostics services, either through referral or sputum collection and transportation (SCT). The objective of this study is to determine additional yield of TB patients achieved by providing SCT services in comparison to referrals of PTBPs identified in hard-to-reach areas. This was before and after comparative study conducted between April-June 2014 (2Q2014-before) to July-September 2014 (3Q2014-after). SCT was advised for all PTBPs identified from community level interventions between July-September 2014 (3Q2014-after). In 3Q2014, additional 279 (34%) PTBPs were examined in the microscopy centre with an additional 36 (51%) new smear positive (NSP) patient diagnosed. A total of 46 NSP (128%) were contributed by SCT alone. Higher proportion (94%) of TB patients was initiated on treatment in 3Q2014 in comparison to 2Q2014 (91%). SCT as a strategy for early case detection in hard-to-reach difficult terrain yields positive results in comparison to mere referral of PTBPs.
Kiosk: An Innovative Client Centric Approach to Tuberculosis Prevention and Care  [PDF]
Janmejaya Samal, Banuru Muralidhara Prasad, Subbanna Jonalgadda, Sripriya Vegendela, Sarabjit Singh Chadha
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.62014
Abstract: Kiosk is a client centric drop-in centre for TB information and services established in urban and peri-urban (slum) settings to provide outreach services under project Axshya. The main objective of the study was to demonstrate the efficacy and feasibility of scaling-up of the model to provide TB services. The assessment was carried out with the help of project recording and reporting formats used to document the information and services provided in the Kiosk from April 2016 to March 2017. The results from retrospective data analysis for services provided at 20 kiosks benefited 16,871 clients; of these 11,252 (66.7%), 1339 (7.9%), 848 (5%), 2911 (17.2%), (1.4%), 273 (1.6%) benefited with TB information, Flexi-DOT, sputum-collection-transportation (SCT), counselling, and domiciliary care respectively. Through active case finding (ACF); 126,893 households were visited and 3593 presumptive-TB-patients received SCT services. A total of 329 TB patients were identified and linked to treatment services of national TB programme. “Kiosk” as a client centric approach would be a novel concept to ensure TB information, TB related services and contribute to ongoing efforts of TB case finding.
Asymptomatic Screening of Clients on Opioid Substitution Therapy for Tuberculosis: An Experience from India  [PDF]
Banuru Muralidhara Prasad, Mandeep Singh, Mukesh Gupta, Thekkur K. Pruthu, Rajeev Kumar, Parmesh C. Bhatnagar, Sarabjit Singh Chadha
Journal of Tuberculosis Research (JTR) , 2019, DOI: 10.4236/jtr.2019.73012
Abstract: Clients on Opioid Substitution Therapy (OST) may be at risk of TB. We screened for tuberculosis in asymptomatic OST clients using Chest-X-ray (CXR) and sputum from those with CXR suggestive of TB were tested using Xpert MTB/Rif. Among 472 who underwent CXR, 0.1% had CXR suggestive of TB. The number needed to screen was 118 clients for one CXR suggestive of TB. All four clients with CXR suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB. The TB patient was asymptomatic and could have been missed through the passive approach. We recommend further studies to explore ACF among OST clients.
Source of Previous Treatment for Re-Treatment TB Cases Registered under the National TB Control Programme, India, 2010
Kuldeep Singh Sachdeva,Srinath Satyanarayana,Puneet Kumar Dewan,Sreenivas Achuthan Nair,Raveendra Reddy,Debasish Kundu,Sarabjit Singh Chadha,Ajay Kumar Madhugiri Venkatachalaiah,Malik Parmar,Lakhbir Singh Chauhan
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0022061
Abstract: In 2009, nearly half (289,756) of global re-treatment TB notifications are from India; no nationally-representative data on the source of previous treatment was available to inform strategies for improvement of initial TB treatment outcome.
Characteristics and Programme-Defined Treatment Outcomes among Childhood Tuberculosis (TB) Patients under the National TB Programme in Delhi
Srinath Satyanarayana,Roopa Shivashankar,Ram Pal Vashist,Lakhbir Singh Chauhan,Sarabjit Singh Chadha,Puneet Kumar Dewan,Fraser Wares,Suvanand Sahu,Varinder Singh,Nevin Charles Wilson,Anthony David Harries
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0013338
Abstract: Childhood tuberculosis (TB) patients under India's Revised National TB Control Programme (RNTCP) are managed using diagnostic algorithms and directly observed treatment with intermittent thrice-weekly short-course treatment regimens for 6–8 months. The assignment into pre-treatment weight bands leads to drug doses (milligram per kilogram) that are lower than current World Health Organization (WHO) guidelines for some patients.
Operational Challenges in Diagnosing Multi-Drug Resistant TB and Initiating Treatment in Andhra Pradesh, India
Sarabjit S. Chadha, Sharath BN, Kishore Reddy, Jyothi Jaju, Vishnu PH, Sreenivas Rao, Malik Parmar, Srinath Satyanarayana, Kuldeep Singh Sachdeva, Nevin Wilson, Anthony D. Harries
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0026659
Abstract: Background Revised National TB Control Programme (RNTCP), Andhra Pradesh, India. There is limited information on whether MDR-TB suspects are identified, undergo diagnostic assessment and are initiated on treatment according to the programme guidelines. Objectives To assess i) using the programme definition, the number and proportion of MDR-TB suspects in a large cohort of TB patients on first-line treatment under RNTCP ii) the proportion of these MDR-TB suspects who underwent diagnosis for MDR-TB and iii) the number and proportion of those diagnosed as MDR-TB who were successfully initiated on treatment. Methods A retrospective cohort analysis, by reviewing RNTCP records and reports, was conducted in four districts of Andhra Pradesh, India, among patients registered for first line treatment during October 2008 to December 2009. Results Among 23,999 TB patients registered for treatment there were 559 (2%) MDR-TB suspects (according to programme definition) of which 307 (55%) underwent diagnosis and amongst these 169 (55%) were found to be MDR-TB. Of the MDR-TB patients, 112 (66%) were successfully initiated on treatment. Amongst those eligible for MDR-TB services, significant proportions are lost during the diagnostic and treatment initiation pathway due to a variety of operational challenges. The programme needs to urgently address these challenges for effective delivery and utilisation of the MDR-TB services.
From Where Are Tuberculosis Patients Accessing Treatment in India? Results from a Cross-Sectional Community Based Survey of 30 Districts
Srinath Satyanarayana, Sreenivas Achutan Nair, Sarabjit Singh Chadha, Roopa Shivashankar, Geetanjali Sharma, Subhash Yadav, Subrat Mohanty, Vishnuvardhan Kamineni, Nevin Charles Wilson, Anthony David Harries, Puneet Kumar Dewan
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0024160
Abstract: Background Tuberculosis (TB) notification in India by the Revised National TB Control Programme (RNTCP) provides information on TB patients registered for treatment from the programme. There is limited information about the proportion of patients treated for TB outside RNTCP and where these patients access their treatment. Objectives To estimate the proportion of patients accessing TB treatment outside the RNTCP and to identify their basic demographic characteristics. Methods A cross sectional community-based survey in 30 districts. Patients were identified through a door-to-door survey and interviewed using a semi-structured questionnaire. Results Of the estimated 75,000 households enumerated, 73,249 households (97.6%) were visited. Of the 371,174 household members, 761 TB patients were identified (~205 cases per 100,000 populations). Data were collected from 609 (80%) TB patients of which 331 [54% (95% CI: 42–66%)] were determined to be taking treatment ‘under DOTS/RNTCP’. The remaining 278 [46% (95% CI: 34–57%)] were on treatment from ‘outside DOTS/RNTCP’ sources and hence were unlikely to be part of the TB notification system. Patients who were accessing treatment from ‘outside DOTS/RNTCP’ were more likely to be patients from rural areas [adjusted Odds Ratio (aOR) 2.5, 95% CI (1.2–5.3)] and whose TB was diagnosed in a non-government health facility (aOR 14.0, 95% CI 7.9–24.9). Conclusions This community-based survey found that nearly half of self-reported TB patients were missed by TB notification system in these districts. The study highlights the need for 1) Reviewing and revising the scope of the TB notification system, 2) Strengthening and monitoring health care delivery systems with periodic assessment of the reach and utilisation of the RNTCP services especially among rural communities, 3) Advocacy, communication and social mobilisation activities focused at rural communities with low household incomes and 4) Inclusive involvement of all health-care providers, especially providers of poor rural communities.
How Do Patients Who Fail First-Line TB Treatment but Who Are Not Placed on an MDR-TB Regimen Fare in South India?
Sharath Burugina Nagaraja, Srinath Satyanarayana, Sarabjit Singh Chadha, Santosha Kalemane, Jyoti Jaju, Shanta Achanta, Kishore Reddy, Vishnu Potharaju, Srinivas Rao Motta Shamrao, Puneet Dewan, Zachariah Rony, Shailaja Tetali, Raghupathi Anchala, Nanda Kishore Kannuri, Anthony David Harries, Sachdeva Kuldeep Singh
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0025698
Abstract: Setting Seven districts in Andhra Pradesh, South India Objectives To a) determine treatment outcomes of patients who fail first line anti-TB treatment and are not placed on an multi-drug resistant TB (MDR-TB) regimen, and b) relate the treatment outcomes to culture and drug susceptibility patterns (C&DST). Design Retrospective cohort study using routine programme data and Mycobacterium TB Culture C&DST between July 2008 and December 2009. Results There were 202 individuals given a re-treatment regimen and included in the study. Overall treatment outcomes were: 68 (34%) with treatment success, 84 (42%) failed, 36 (18%) died, 13 (6.5%) defaulted and 1 transferred out. Treatment success for category I and II failures was low at 37%. In those with positive cultures, 81 had pan-sensitive strains with 31 (38%) showing treatment success, while 61 had drug-resistance strains with 9 (15%) showing treatment success. In 58 patients with negative cultures, 28 (48%) showed treatment success. Conclusion Treatment outcomes of patients who fail a first-line anti-TB treatment and who are not placed on an MDR-TB regimen are unacceptably poor. The worst outcomes are seen among category II failures and those with negative cultures or drug-resistance. There are important programmatic implications which need to be addressed.
Revised National Tuberculosis Control Programme (RNTCP) Tribal Action Plan Fund Utilisation: How Does Chhattisgarh State in India Fare?  [PDF]
Gayadhar Mallick, Sharath Burugina Nagaraja, Karuna D. Sagili, Kshitij Khaparde, Srinath Satyanarayana, Sarabjit Chadha
Journal of Tuberculosis Research (JTR) , 2019, DOI: 10.4236/jtr.2019.71001
Abstract: Background: In India, tuberculosis remains as a major public health problem amongst the tribal population. Poor physical access to diagnosis and treatment under the Revised National TB control programme (RNTCP) still remains the problem for the population. RNTCP implements Tribal Action Plan (TAP) for tribal patients. We conducted the study to determine the trends of financial utilisation for the special provisions available under tribal action plan like patient honorarium, incentive for sputum collection and transport, incentive for programme staff and incentive for vehicle maintenance. Methods: A cross-sectional study based on mixed method study approach was conducted in Chhattisgarh, India during Nov. 16 to Jun. 17. District TB Officers implementing TAP were interviewed telephonically using a semi-structured questionnaire to ascertain and analyse the reasons for low fund utilization in their districts. Retrospective financial data for five financial years from 13 TAP districts for 2012-2013 to 2016-2017 was collected, compiled and analysed. Results: Overall, the trends on states expenditure on tribal action plan in terms of absolute numbers has increased over the past five years; however, in terms of fund utilization against received ranges from 37% - 86% with the utilization rate less than 44% in the recent years (2014-2017). Conclusion: The trends of utilisation of TAP is less than 44% over the recent years. There is an urgent need for the administrators to intervene and improve the efficiency of fund utilisation at State and district levels.
Is One Sputum Specimen as Good as Two during Follow-Up Cultures for Monitoring Multi Drug Resistant Tuberculosis Patients in India?
Sharath Burugina Nagaraja, Ajay M. V. Kumar, Kuldeep Singh Sachdeva, Ranjani Ramachandran, Srinath Satyanarayana, Avi Bansal, Malik Parmar, Sarabjit Chadha, Sreenivas Nair, Ashok Kumar, Sven Gudmund Hinderaker, Mary Edginton, Puneet K. Dewan
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0045554
Abstract: Background In India, the Revised National Tuberculosis Control Programme (RNTCP) has adopted the strategy of examining two specimens during follow-up culture examinations to monitor the treatment response of multi-drug resistant tuberculosis (MDR-TB) patients. Objectives To determine the incremental yield of the second sputum specimen during follow-up culture examinations among patients with MDR-TB and the effect on case management on changing from two to one specimen follow-up strategy. Methods A cross sectional record review of MDR-TB patients registered during 2008–09 under RNTCP was undertaken in three MDR-TB treatment sites of India. Results Of 1721 pairs of follow-up sputum culture examinations done among 220 MDR-TB patients, 451(26%) were positive with either of the two specimens; 29(1.7%) were culture positive only on the second specimen indicating the incremental yield. To detect one additional culture positive result on the second specimen, 59 specimens needed to be processed. If we had examined only one specimen, we would have missed 29 culture-positive results. By current RNTCP guidelines, however, a single specimen policy would have altered case management in only 3(0.2%) instances, where patients would have missed a one month extension of the intensive phase of MDR-TB treatment. There is no meaningful advantage in using two specimens for the monitoring of MDR-TB patients. A single specimen policy could be safely implemented with negligible clinical effect on MDR-TB patients and favourable resource implications for RNTCP.
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