The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) Project: An Operational Assessment

Int J Tuberc Lung Dis. 2011 Jun;15 Suppl 2(Suppl 2):50-57. doi: 10.5588/ijtld.10.0447.

Abstract

Setting: Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru.

Objective: To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services.

Design: Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months.

Results: Poverty (46% earned <US$1 per day), depression (40%), stigmatisation (77%), and perceived isolation (39%) were common among TB patients (all P < 0.05 vs. non-patients). The project had 100% recruitment, and involved 97% of TB-affected households in regular visits, 71% in community groups, 78% in psychosocial support and 77% in poverty-reduction interventions. The socio-economic interventions were associated with increases in household contact TB screening (from 82% to 96%); successful TB treatment completion (from 91% to 97%); patient human immunodeficiency virus testing (from 31% to 97%); and completion of preventive therapy (from 27% to 87%; all P < 0.0001).

Conclusions: Socio-economic interventions can strengthen TB control activities.

Keywords: tuberculosis; control; microcredit; poverty;social determinants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communicable Disease Control / economics*
  • Community Networks / economics
  • Developing Countries / economics*
  • Financial Management / economics
  • Health Behavior
  • Health Care Costs*
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / economics
  • Health Services Accessibility / economics
  • Humans
  • Income
  • Nutritional Status
  • Patient Acceptance of Health Care
  • Patient Education as Topic / economics
  • Peru
  • Poverty Areas
  • Program Evaluation
  • Risk Assessment
  • Risk Factors
  • Small Business / economics
  • Social Support
  • Socioeconomic Factors*
  • Time Factors
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy
  • Tuberculosis / economics*
  • Tuberculosis / prevention & control*
  • Tuberculosis / psychology
  • Vocational Education