title: A pragmatic approach to measuring, monitoring and evaluating interventions for improved tuberculosis case detection.
abstract: The inability to detect all individuals with active tuberculosis has led to a growing interest in new approaches to improve case detection. Policy makers and program staff face important challenges measuring effectiveness of newly introduced interventions and reviewing feasibility of scaling-up successful approaches. While robust research will continue to be needed to document impact and influence policy, it may not always be feasible for all interventions and programmatic evidence is also critical to understand what can be expected in routine settings. The effects of interventions on early and improved tuberculosis detection can be documented through well-designed program evaluations. We present a pragmatic framework for evaluating and measuring the effect of improved case detection strategies using systematically collected intervention data in combination with routine tuberculosis notification data applying historical and contemporary controls. Standardized process evaluation and systematic documentation of program implementation design, cost and context will contribute to explaining observed levels of success and may help to identify conditions needed for success. Findings can then guide decisions on scale-up and replication in different target populations and settings.
authors.affiliation: KIT Health, Royal Tropical Institute, 1090 HA, Amsterdam, Netherlands.
authors.forename: Lucie
authors.initials: L
authors.lastname: Blok
authors.affiliation: Stop TB Partnership, Secretariat 20 Ave Appia, Geneva 1211, Switzerland creswellj@who.int.
authors.forename: Jacob
authors.initials: J
authors.lastname: Creswell
authors.affiliation: HLSP, London, EC4M 7RB, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Stevens
authors.affiliation: PHTB Consult, Tilburg, Netherlands.
authors.forename: Miranda
authors.initials: M
authors.lastname: Brouwer
authors.affiliation: HLSP, London, EC4M 7RB, UK.
authors.forename: Oriol
authors.initials: O
authors.lastname: Ramis
authors.affiliation: HLSP, London, EC4M 7RB, UK.
authors.forename: Olivier
authors.initials: O
authors.lastname: Weil
authors.affiliation: KIT Biomedical Research, Royal Tropical Institute, 1105 AZ, Amsterdam, Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Klatser
authors.affiliation: Stop TB Partnership, Secretariat 20 Ave Appia, Geneva 1211, Switzerland.
authors.forename: Suvanand
authors.initials: S
authors.lastname: Sahu
authors.affiliation: KIT Biomedical Research, Royal Tropical Institute, 1105 AZ, Amsterdam, Netherlands.
authors.forename: Mirjam I
authors.initials: MI
authors.lastname: Bakker
mesh_terms: D016358:Contact Tracing / Q000379:methods; D018563:Disease Notification / Q000379:methods*; D062665:Epidemiological Monitoring; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D018571:Sentinel Surveillance; D014376:Tuberculosis / Q000175:diagnosis* / Q000517:prevention & control
keywords: Active case finding; Case detection; Screening; Tuberculosis
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