Feasibility and Performance of Accredited Social Health Activist (ASHA) led Active Case Finding (ACF) Strategy for Tuberculosis in a Community Health Block of Himachal Pradesh

Abstract

Village level inclusion of Accredited Social Health Activist (ASHA) for early diagnosis and treatment of Tuberculosis (TB) expects increase in case detection. Study was done to assess the feasibility and performance of ASHA led active case finding (ACF) strategy for TB. In a health block with a total population of about 0.18 million, 88 out of 210 ASHAs, were incentivized to screen 44,589 individuals of more than 18 years of age for presumptive TB. A project staff, as a support to ASHA, was recruited for collection of sputum specimens for testing and communicating the results back to ASHAs. ACF identified 489 (1.1%) presumptive cases and 19 confirmed cases of sputum positive pulmonary TB with case detection rate of 0.42/100,000 population additional to already registered cases under RNTCP. Timely and appropriate incentives along with supportive supervision are critical steps for effective execution of desired deliverables ASHA for TB control.