SYSTEMATIC REVIEW AND METANALYSIS ON COMMUNITY BASED INTERVENTIONS IN TUBERCULOSIS CARE IN DEVELOPING COUNTRIES

Dr Baba Maiyaki Musa, Dr Zubairu Iliyasu, Dr Shehu Muhammad Yusuf, Dr Andy E. Uloko

Available online Jul 18, 2018.

[ Review ] Volume 23, Issue 2, 2014, Pages 103-117


Abstract

Background We aimed to evaluate the effectiveness of Lay Health Workers (LHW) in increasing case
detection rate and treatment success outcome of Tuberculosis cases
Methods PUBMED,; Google scholar ,African Journal Online (AJOL) and other search engines were
systematically searched, for literature from 2000 to 2012 for studies that are either: [randomized/cluster
randomized/non randomized or prospective cohort study]; assessing lay Health care worker participation
in tuberculosis (TB) treatment, using the key words (LHW, TB and treatment). Studies were pooled using a
random effect model. Of the thirteen studies that fulfilled the inclusion criteria for systemic review, only five
were heterogeneous enough for a meta-analysis.
Results There was a marginal effectiveness of LHW involvement in TB treatment success rate, RR 1.09
Confidence Interval. [0.98-1.21] . There was no publication bias; with {p=0.135 for Eggar's weighed
regression analysis}. Restrictive analysis showed a marginally higher summary relative risk in rural based
studies RR 1.12, C.I. [1.01-1.24]; compared to urban studies RR 1.01, C.I. [0.91-1.13].
Conclusion The use of Lay Health care workers is associated with a marginal benefit in improving TB
treatment success compared to standard facility based TB care. Larger studies are needed to properly
prove its superiority.


Keywords

META-ANALYSIS COMMUNITY PARTICATION TUBERCULOSIS,