“IMPACT OF COMMUNITY-BASED AWARENESS INTERVENTIONS ON EARLY CASE DETECTION AND REFERRAL OF TUBERCULOSIS IN HIGH-BURDEN AREAS”
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Keywords
Tuberculosis, Community awareness, Early detection, Referral, ASHA workers, NTEP, IEC, BCC, Gujarat
Abstract
Background: Tuberculosis (TB) continues to be a major public health burden in India, particularly due to delayed diagnosis, poor awareness, and under-utilization of referral services. Community-based awareness interventions under the National Tuberculosis Elimination Programme (NTEP) aim to enhance early symptom recognition and timely healthcare-seeking behavior. This study evaluates the impact of such interventions on early TB case detection and referral in high-burden areas.
Objectives: To assess the effectiveness of community-based awareness interventions on early TB case detection and referral rates, and to identify determinants influencing community participation and healthcare-seeking behavior.
Methods: This quasi-experimental, community-based interventional study was conducted in two blocks of Gujarat from August 2024 to March 2025. One block received structured awareness interventions including door-to-door visits by ASHAs, IEC/BCC campaigns, and group meetings facilitated by TB Champions; the other block served as a control. Pre- and post-intervention data were collected on presumptive TB symptomatics screened, referrals made, and microbiologically confirmed TB cases. Statistical analysis included Chi-square tests and logistic regression using SPSS v25.
Results: Following the intervention, the number of early TB referrals increased by 38% in the intervention block compared to 12% in the control block (p<0.001). Significant predictors of referral included household visits by ASHAs (OR=3.2, p=0.004), attendance in TB group meetings (OR=2.8, p=0.01), and correct awareness of TB symptoms (OR=4.1, p=0.001).
Conclusion: Community-based awareness interventions significantly enhanced early TB case detection and referrals. Integrating grassroots health workers and culturally appropriate awareness tools under NTEP can improve health-seeking behavior and facilitate early diagnosis in high-burden communities.
References
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4. Prasad BM, et al. Improving TB care through community engagement: experiences from India. Indian J Tuberc. 2020;67(4):319–25.
5. Rao VG, et al. Tuberculosis among underserved populations in India: a systematic review. J Glob Infect Dis. 2019;11(3):120–6.
6. Singh V, et al. Role of frontline health workers in improving TB detection in low-literacy settings. Int J Tuberc Lung Dis. 2021;25(7):562–7.
7. Bhatt G, et al. Effectiveness of IEC activities on TB awareness and health-seeking behavior. J Commun Dis. 2022;54(1):48–54.
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Dr. Binal Prajapati
Assistant Professor, Community Medicine Department, GMERS Medical college and Hospital, Dharpur- Patan
Dr. Ilesh Patel
Senior Resident, Respiratory Medicine Department, GMERS Medical college and Hospital, Dharpur- Patan
Dr. Parimal Gurjar
Assistant Professor, Respiratory Medicine Department, GMERS Medical college and Hospital, Dharpur- Patan