Effect of Integrating Traditional Tuberculosis Care With Modern Health Care on Case Detection

Summary

Although many interventions are implemented to increase TB case detection, decrease diagnosis delay, and avoid catastrophic costs, there are no significant changes and the end TB goal will not be achieved in 2035. Innovative intervention that considers indigenous knowledge and unique culture and religious perspectives because many people go to traditional healers and holy water for healing. Therefore, integrating traditional tuberculosis care with modern care increase case detection, decrease diagnosis delay, and avoid catastrophic costs. There is no literature clearly defining integrating traditional TB care with modern care, but for the purpose of this study, integrating traditional care with modern care is defined as the collaboration of two systems through referral linkage. TB screening and diagnosis services will be done collaboratively in traditional and modern care services. A referral linkage model will be used to detect TB cases in both traditional and modern care services. Health care providers, traditional healers, priests, pastors, and imams will participate in the integration process. TB detection or diagnosis services will be integrated through referral linkage and strengthening capacity-building strategies. Traditional care centers and modern health care services will work collaboratively to improve TB case detection, reduce care costs, and avoid diagnosis delays. The standardized operational procedure of the full interventional package is described below.

There are four steps of the intervention phases. These are the preliminary phase, preparation for implementation and refinement on a small scale phase, administering the intervention, and end-line assessment of outcomes. The intervention will be providing training for traditional and modern care practitioners, patient education, TB screening, and bidirectional referral linkage.

This study hypothesized that integrating traditional care with modern care at the primary care level will increase the TB case detection rate by fifteen percentage points. Integrating traditional care with modern care at the primary care level will decrease TB diagnosis delay by fifteen percentage points. Integrating traditional care with modern care at the primary care level also will decrease the cost of TB care by 15 percentages of points

Conditions

• Tuberculosis
• Tuberculosis, Pulmonary
• Tuberculosis Infection

Interventions

OTHER

Training for traditional and modern care providers

The intervention arm includes training for traditional and modern care providers, patient education, screening, and referring to TB suspected cases plus the usual care. The training will be provided three times which will be delivered every three months. In the first round, traditional practitioners will be trained for 5 days. In this round, the training will be also delivered to modern health care providers on how to communicate and work with traditional care providers for 2-day. Then, a one-day interactive discussion session will be prepared for both traditional and modern care providers. In the second round and third rounds, one-day training will be carried out at three and six months. TB suspected cases at traditional foster and holy water and patients who need spiritual support from health care providers will be screened every case in every day for one year. Referring to TB suspected cases will also apply for every case every day for one year

Sponsors & Collaborators

• Bahir Dar University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2022-07-01

Primary Completion

2023-12-30

Completion

2023-12-30

Countries

• Ethiopia

Study Locations