Tuberculosis control in a socially vulnerable area: A community intervention beyond DOT in a Brazilian favela

Elizabeth C C Soares, W. M. Vollmer, S. C. Cavalcante, A. G. Pacheco, V. Saraceni, J. S. Silva, G. R. Neves, Jonathan E Golub, A. R. Efron, B. Durovni, Richard E Chaisson

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To evaluate the population-based impact of a comprehensive intervention to strengthen tuberculosis (TB) control in Rocinha, the largest urban slum in Rio de Janeiro, Brazil. DESIGN: In July 2003, 40 lay persons were hired and trained as community health workers to supervise treatment, implement educational activities and establish a supportive social network for anti-tuberculosis treatment. Between July 2005 and June 2008, a door-to-door active case finding campaign was conducted. Data were obtained from the Brazilian National Reporting System, which collects information from the TB notification form for every reported case. RESULTS: Between January 2001 and December 2008, 2623 TB cases were reported, 852 before and 1771 after the start of the program. Following the intervention, treatment success rates increased (67.6% vs. 83.2%, P <0.001) and default rates dropped (17.8% vs. 5.5%, P <0.001). Compared to the pre-intervention period, the TB case rate declined by an average of 39 cases per 100 000 population per 6 months (P = 0.003) in the post-intervention period, although this may have been due to secular trends already in place at the start of the intervention. Case rates declined from 591/100 000 in 2001 to 496/100 000 in 2008. CONCLUSION: With proper planning and effective community involvement, a successful intervention can lead to high cure rates and may contribute to a decrease in TB notification rates.

Original languageEnglish (US)
JournalInternational Journal of Tuberculosis and Lung Disease
Volume17
Issue number12
DOIs
StatePublished - Dec 1 2013

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Tuberculosis
Poverty Areas
Social Support
Population
Brazil
Therapeutics
Education

Keywords

  • Community health workers
  • Incidence rate
  • Slum
  • TB case notification rate

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Tuberculosis control in a socially vulnerable area : A community intervention beyond DOT in a Brazilian favela. / Soares, Elizabeth C C; Vollmer, W. M.; Cavalcante, S. C.; Pacheco, A. G.; Saraceni, V.; Silva, J. S.; Neves, G. R.; Golub, Jonathan E; Efron, A. R.; Durovni, B.; Chaisson, Richard E.

In: International Journal of Tuberculosis and Lung Disease, Vol. 17, No. 12, 01.12.2013.

Research output: Contribution to journalArticle

Soares, Elizabeth C C ; Vollmer, W. M. ; Cavalcante, S. C. ; Pacheco, A. G. ; Saraceni, V. ; Silva, J. S. ; Neves, G. R. ; Golub, Jonathan E ; Efron, A. R. ; Durovni, B. ; Chaisson, Richard E. / Tuberculosis control in a socially vulnerable area : A community intervention beyond DOT in a Brazilian favela. In: International Journal of Tuberculosis and Lung Disease. 2013 ; Vol. 17, No. 12.
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