The Impact of Involving Informal Health Providers for Tuberculosis Control in Sudan (Triage-Plus)

Liverpool School of Tropical Medicine

Status: Completed

Conditions: Tuberculosis

Treatments: Behavioral: Referral of presumptive of TB cases by informal providers

Study type: Interventional

Funder types: Other

Identifiers

NCT01841541

11.03RS

Details and patient eligibility

About

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.

Full 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.

Enrollment: 380 patients

Sex: All

Ages: 14+ years old

Volunteers: No Healthy Volunteers

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)

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

380 participants in 2 patient groups

Ombda Locality: informal providers

Experimental group

Description:

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.

Treatment:

Behavioral: Referral of presumptive of TB cases by informal providers

Jabal Awlia Locality

No Intervention group

Description:

The control arm: A locality in south eastern site of Khartoum state populated with 942,429. No intervention took place