title: Addressing tuberculosis patients' medical and socio-economic needs: a comprehensive programmatic approach.
abstract: For a cohort of patients with tuberculosis in Carabayllo, Peru, we describe the prevalence of medical comorbidities and socio-economic needs, the efforts required by a comprehensive support programme ('TB Cero') to address them and the success of this programme in linking patients to care.
  
  
  
  Patients diagnosed with tuberculosis in Carabayllo underwent evaluations for HIV, diabetes, mental health and unmet basic needs. For patients initiating treatment during 14 September, 2015-15 May, 2016, we abstracted data from evaluation forms and a support request system. We calculated the prevalence of medical comorbidities and the need for socio-economic support at the time of tuberculosis diagnosis, as well as the proportion of patients successfully linked to care or support.
  
  
  
  Of 192 patients, 83 (43%) had at least one medical comorbidity other than tuberculosis. These included eight (4%) patients with HIV, 12 (6%) with diabetes and 62 (32%) deemed at risk for a mental health condition. Of patients who required follow-up for a comorbidity, 100% initiated antiretroviral therapy, 71% attended endocrinology consultations and 66% attended psychology consultations. Of 126 (65%) patients who completed the socio-economic evaluation, 58 (46%) reported already receiving food baskets from the municipality, and 79 (63%) were given additional support, most commonly food vouchers and assistance in accessing health care.
  
  
  
  Carabayllo tuberculosis patients face many challenges in addition to tuberculosis. A collaborative, comprehensive treatment support programme can achieve high rates of linkage to care for these needs.
authors.affiliation: Socios En Salud Sucursal Peru, Lima, Perú.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Contreras
authors.affiliation: Socios En Salud Sucursal Peru, Lima, Perú.
authors.forename: Ana K
authors.initials: AK
authors.lastname: Millones
authors.affiliation: Socios En Salud Sucursal Peru, Lima, Perú.
authors.forename: Janeth
authors.initials: J
authors.lastname: Santa Cruz
authors.affiliation: Socios En Salud Sucursal Peru, Lima, Perú.
authors.forename: Margot
authors.initials: M
authors.lastname: Aguilar
authors.affiliation: Ministry of Health, Lima, Perú.
authors.forename: Martin
authors.initials: M
authors.lastname: Clendenes
authors.affiliation: Ministry of Health, Lima, Perú.
authors.forename: Miguel
authors.initials: M
authors.lastname: Toranzo
authors.affiliation: Socios En Salud Sucursal Peru, Lima, Perú.
authors.forename: Karim
authors.initials: K
authors.lastname: Llaro
authors.affiliation: Socios En Salud Sucursal Peru, Lima, Perú.|Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
authors.forename: Leonid
authors.initials: L
authors.lastname: Lecca
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.|Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Mercedes C
authors.initials: MC
authors.lastname: Becerra
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.|Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Courtney M
authors.initials: CM
authors.lastname: Yuen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003191:Comprehensive Health Care; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult
keywords: Peru; Perú; Pérou; comorbidity; comorbidité; comorbilidad; mental health; salud mental; santé mentale; tuberculose; tuberculosis