title: The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project: an operational assessment.
abstract: METHODS
  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.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  tuberculosis; control; microcredit; poverty;social determinants.
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: C
authors: C
authors: Rocha
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: R
authors: R
authors: Montoya
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: K
authors: K
authors: Zevallos
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: A
authors: A
authors: Curatola
authors: Asociación Benéfica Prisma, Lima, Peru; Microfinanzas Prisma, Lima, Peru.
authors: W
authors: W
authors: Ynga
authors: Asociación Benéfica Prisma, Lima, Peru; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: J
authors: J
authors: Franco
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: F
authors: F
authors: Fernandez
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: N
authors: N
authors: Becerra
authors: Asociación Benéfica Prisma, Lima, Peru.
authors: M
authors: M
authors: Sabaduche
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: M A
authors: MA
authors: Tovar
authors: IFHAD: Innovation For Health And Development, London, UK; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: E
authors: E
authors: Ramos
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: A
authors: A
authors: Tapley
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: N R
authors: NR
authors: Allen
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: D A
authors: DA
authors: Onifade
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: C D
authors: CD
authors: Acosta
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru.
authors: M
authors: M
authors: Maritz
authors: Microfinanzas Prisma, Lima, Peru.
authors: D F
authors: DF
authors: Concha
authors: IFHAD: Innovation For Health And Development, London, UK; Asociación Benéfica Prisma, Lima, Peru; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors: S G
authors: SG
authors: Schumacher
authors: IFHAD: Innovation For Health And Development, London, UK; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru; Wellcome Centre for Clinical Tropical Medicine and Department of Infection & Immunity, Imperial College, London, UK; and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
authors: C A
authors: CA
authors: Evans
mesh_terms: D003140:Communicable Disease Control / Q000191:economics*; D019058:Community Networks / Q000191:economics; D003906:Developing Countries / Q000191:economics*; D005376:Financial Management / Q000191:economics; D015438:Health Behavior; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007182:Income; D009752:Nutritional Status; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000191:economics; D010568:Peru; D011204:Poverty Areas; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D058012:Small Business / Q000191:economics; D012944:Social Support; D012959:Socioeconomic Factors; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics* / Q000517:prevention & control* / Q000523:psychology; D014829:Vocational Education