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Barriers To Access Of Healthcare Services For Rural Women – Applying Gender Lens On Tb In A Rural District Of Sindh, Pakistan, Shifa Salman Habib, Wafa Zehra Jamal, Syed Muhammad Asad Zaidi, Junaid Ur-Rehman Siddiqui, Hira Mustafa Khan, Jacob Creswell, Srichand Batra, Anna Versfeld Jul 2021

Barriers To Access Of Healthcare Services For Rural Women – Applying Gender Lens On Tb In A Rural District Of Sindh, Pakistan, Shifa Salman Habib, Wafa Zehra Jamal, Syed Muhammad Asad Zaidi, Junaid Ur-Rehman Siddiqui, Hira Mustafa Khan, Jacob Creswell, Srichand Batra, Anna Versfeld

Community Health Sciences

Background: Women in rural districts of Pakistan face numerous barriers to healthcare, rendering gender-responsive health programming important, including for Tuberculosis (TB). This study was conducted to assess the general understanding of TB and of access to healthcare for women, as a first step towards implementation of a gender responsive TB programme in TandoAllayar, a rural district of Pakistan.
Methods: A total of 36 participants were interviewed. The focus group discussion guide comprised of questions on: (1) family/household dynamics (2) community norms (3) healthcare system (4) women’s access to healthcare (5) TB Awareness;, and (6) women’s access to TB Care.
Results: …


Tuberculosis And Non-Communicable Disease Multimorbidity: An Analysis Of The World Health Survey In 48 Low- And Middle-Income Countries, Brendon Stubbs, Kamran Siddiqi, Helen Elsey, Najma Siddiqi, Ruimin Ma, Eugenia Romano, Sameen Siddiqi, Ai Koyanagi Mar 2021

Tuberculosis And Non-Communicable Disease Multimorbidity: An Analysis Of The World Health Survey In 48 Low- And Middle-Income Countries, Brendon Stubbs, Kamran Siddiqi, Helen Elsey, Najma Siddiqi, Ruimin Ma, Eugenia Romano, Sameen Siddiqi, Ai Koyanagi

Community Health Sciences

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38-4.0). Prevalence …


Engagement Of Private Healthcare Providers For Case Finding Of Tuberculosis And Diabetes Mellitus In Pakistan, Shifa Salman Habib, Sana Rafiq, Wafa Zehra Jamal, Shaikh Muhammad Ayub, Rashida Abbas Ferrand, Aamir Khan, Syed Mohammad Asad Zaidi Apr 2020

Engagement Of Private Healthcare Providers For Case Finding Of Tuberculosis And Diabetes Mellitus In Pakistan, Shifa Salman Habib, Sana Rafiq, Wafa Zehra Jamal, Shaikh Muhammad Ayub, Rashida Abbas Ferrand, Aamir Khan, Syed Mohammad Asad Zaidi

Community Health Sciences

Background: The rising co-epidemic of tuberculosis (TB) and diabetes mellitus (DM) is a challenge for constrained health systems in low and middle-income countries. Diabetes is a known risk factor for tuberculosis and associated with poor tuberculosis treatment outcomes, while tuberculosis is associated with worsening glycemic control. We investigated the performance of bi-directional TB and DM case finding approaches through a private-sector engagement model in Karachi, Pakistan.
Methods: Between July 2016 and July 2018, private health care providers were engaged to generate referrals for bi-directional TB and DM screening at private diagnostic and treatment centers in Karachi, Pakistan. Individuals diagnosed with …


Evaluation Of Computer Aided Detection Of Tuberculosis On Chest Radiography Among People With Diabetes In Karachi Pakistan, Shifa Salman Habib, Sana Rafiq, Syed Mohammad Asad Zaidi, Rashida Abbas Ferrand, Jacob Creswell, Bram Van Ginneken, Wafa Zehra Jamal, Kiran Sohail Azeemi, Saira Khowaja, Aamir Khan Apr 2020

Evaluation Of Computer Aided Detection Of Tuberculosis On Chest Radiography Among People With Diabetes In Karachi Pakistan, Shifa Salman Habib, Sana Rafiq, Syed Mohammad Asad Zaidi, Rashida Abbas Ferrand, Jacob Creswell, Bram Van Ginneken, Wafa Zehra Jamal, Kiran Sohail Azeemi, Saira Khowaja, Aamir Khan

Community Health Sciences

Pakistan ranks fifth among high tuberculosis (TB) burden countries and also has seventh highest burden for diabetes mellitus (DM). DM increases the risk of developing TB and contributes to adverse TB treatment outcomes hence screening and integrated management for both diseases in high burden countries is suggested. Computer-Aided Detection for TB (CAD4TB) can potentially be used as triage tool in low resource settings to pre-screen individuals for Xpert MTB/RIF testing. The aim of this study was to evaluate the diagnostic accuracy and performance of CAD4TB software in people with diabetes (PWD) enrolled in a TB screening program in Karachi, Pakistan. …


Computer Aided Detection Of Tuberculosis On Chest Radiographs: An Evaluation Of The Cad4tb V6 System, Keelin Murphy, Shifa Salman Habib, Syed Mohammad Asad Zaidi, Saira Khowaja, Aamir Khan, Jaime Melendez, Ernst T. Scholten, Farhan Amad, Steven Schalekamp, Maurits Verhagen Mar 2020

Computer Aided Detection Of Tuberculosis On Chest Radiographs: An Evaluation Of The Cad4tb V6 System, Keelin Murphy, Shifa Salman Habib, Syed Mohammad Asad Zaidi, Saira Khowaja, Aamir Khan, Jaime Melendez, Ernst T. Scholten, Farhan Amad, Steven Schalekamp, Maurits Verhagen

Community Health Sciences

There is a growing interest in the automated analysis of chest X-Ray (CXR) as a sensitive and inexpensive means of screening susceptible populations for pulmonary tuberculosis. In this work we evaluate the latest version of CAD4TB, a commercial software platform designed for this purpose. Version 6 of CAD4TB was released in 2018 and is here tested on a fully independent dataset of 5565 CXR images with GeneXpert (Xpert) sputum test results available (854 Xpert positive subjects). A subset of 500 subjects (50% Xpert positive) was reviewed and annotated by 5 expert observers independently to obtain a radiological reference standard. The …


Operationalization Of Bi-Directional Screening For Tuberculosis And Diabetes In Private Sector Healthcare Clinics In Karachi, Pakistan, Mashal S. Basir, Shifa Salman Habib, Syed M A. Zaidi, Saira Khowaja, Hamidah Hussain, Rashida A. Ferrand, Aamir J. Khan Mar 2019

Operationalization Of Bi-Directional Screening For Tuberculosis And Diabetes In Private Sector Healthcare Clinics In Karachi, Pakistan, Mashal S. Basir, Shifa Salman Habib, Syed M A. Zaidi, Saira Khowaja, Hamidah Hussain, Rashida A. Ferrand, Aamir J. Khan

Community Health Sciences

Background: Many countries are facing overlapping epidemics of tuberculosis (TB) and diabetes mellitus (DM). Diabetes increases the overall risk of developing Tuberculosis (TB) and contributes to adverse treatment outcomes. Active screening for both diseases can reduce TB transmission and prevent the development of complications of DM. We investigated bi-directional TB-DM screening in Karachi, Pakistan, a country that ranks fifth among high TB burden countries, and has the seventh highest country burden for DM.
Methods: Between February to November 2014, community-based screeners identified presumptive TB and DM through verbal screening at private health clinics. Individuals with presumptive TB were referred for …


Daily Contact With A Patient And Poor Housing Affordability As Determinants Of Pulmonary Tuberculosis In Urban Pakistan, Batool A. Haider, Saeed Akhtar, Juanita Hatcher Mar 2013

Daily Contact With A Patient And Poor Housing Affordability As Determinants Of Pulmonary Tuberculosis In Urban Pakistan, Batool A. Haider, Saeed Akhtar, Juanita Hatcher

Community Health Sciences

Objective: This study aimed to evaluate the factors associated with pulmonary tuberculosis (TB) among individuals aged 15years or more in urban Karachi, Pakistan.DESIGN AND SETTING: A case-control design was implemented in three major tertiary-care hospitals to select cases (n=342) with active pulmonary TB (i.e. two sputum smears positive for Mycobacterium tuberculosis with clinical and radiographic evidence of current pulmonary TB and diagnosed between August 2002 and October 2003. Selected controls (n=342) were surgery patients from the same hospitals at time of recruitment of the cases, without clinical and radiographic evidence of pulmonary TB.Results: Multivariable logistic regression model showed that daily …


Public Private Mix Model In Enhancing Tuberculosis Case Detection In District Thatta, Sindh, Pakistan, Jameel Ahmed, Mubashir Ahmed, A Laghari, Wasdev Lohana, Sajid Ali, Zafar Fatmi Feb 2009

Public Private Mix Model In Enhancing Tuberculosis Case Detection In District Thatta, Sindh, Pakistan, Jameel Ahmed, Mubashir Ahmed, A Laghari, Wasdev Lohana, Sajid Ali, Zafar Fatmi

Community Health Sciences

To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) …