The Impact of Involving Informal Health Providers for Tuberculosis Control in Sudan

Not Applicable

Completed

• Conditions: Tuberculosis
• Interventions: Behavioral: Referral of presumptive of TB cases by informal providers

• Registration Number: NCT01841541
• Lead Sponsor: Liverpool School of Tropical Medicine

Brief Summary

Training and engaging of unpaid informal providers (such as tea-sellers, women's groups, youth clubs, small traders and religious groups) from poorer localities in TB disease recognition, referral and community awareness raising will increase the access of TB patients to formal health facilities and decrease their delay in initiating TB treatment.

Detailed Description

Barriers to accessing health services faced by poor and vulnerable populations are numerous in developing countries. These include; geography, income poverty, lack of trust in the quality of public health services, and lack of empowerment of women and adolescent girls (as patients and carers) to mobilize adequate and timely resources to access these services.

The project aims to test if TB case detection can be increased by engaging informal health care providers in active case finding. In one urban district of Khartoum, these providers will be trained to work as first point of entry to the health system using a comprehensive package that includes disease recognition, health communication, and patient referral. In a comparator urban district of Khartoum, no attempts will be made to engage informal providers.

By comparing data of TB patients and Lab registers between the intervention and comparator districts in Khartoum, this project aims to test if, and to what extent, these expected effects can be realized.

Overall this is a trial of a health policy so individual patients will not be recruited or randomized to one intervention or the other. Rather the policy is being applied in one district while the other district is being used as a comparator.

Study Timeline

• Study Start: 2009-01
• Primary Completion: 2012-03
• Study Completion: 2012-04
• Status Verified: 2013-04
• Study First Submitted: 2013-04-24
• Study First Submitted QC: 2013-04-25
• Last Update Submitted: 2013-04-25
• Study First Posted: 2013-04-26
• Last Update Posted: 2013-04-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 380

Inclusion Criteria

• Access point for health seeking by the poor and vulnerable
• Active and well known in community
• Intervention activities can be confined to intervention area
• Based in community/locality
• Longevity; long standing
• Present in control and intervention areas
• Able and willing to complete the training to be Triage-Plus providers (ie giving formal consent)

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Exclusion Criteria

• Formal health providers, e.g. clinics, labs, hospitals (MOH, NGO or private)
• Internationally funded organizations, e.g. international NGOs
• Civil servants e.g. teachers

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Ombda Locality: informal providers	Referral of presumptive of TB cases by informal providers	Ombda locality is located in Western Khartoum and populated with population size of 988,163. Intervention: 380 unpaid Informal providers trained to recognise TB symptoms and to refer presumptive TB cases to formal health care facilities within the area.

Primary Outcome Measures

Name	Time	Method
Total number of TB patients registered and start receiving treatment in formal health care facilities	12 months	This will be measured by comparing Data from routine patients registered in formal TB management units in the intervention arm and compare it with the same routine data from the control arm. similar data for the previous year will undergo the same comparison as time control for both arms

Trial Locations

Locations (1)

The Epidemiological Laboratory (EpiLab); 🇸🇩 Khartoum, Sudan