title: The contribution of a non-governmental organisation's Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time.
abstract: BACKGROUND
  It is estimated that the standard, passive case finding (PCF) strategy for detecting cases of tuberculosis (TB) in Myanmar has not been successful: 26% of cases are missing. Therefore, alternative strategies, such as active case finding (ACF) by community volunteers, have been initiated since 2011. This study aimed to assess the contribution of a Community Based TB Care Programme (CBTC) by local non-government organizations (NGOs) to TB case finding in Myanmar over 4 years.
  
  
  METHODS
  This was a descriptive study using routine, monitoring data. Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database. Data from all 84 project townships in five regions and three states in Myanmar were used. The project was launched in 2011.
  
  
  RESULTS
  Over time, the number of presumptive TB cases that were referred decreased, except in the Yangon Region, although in some areas, the numbers fluctuated. At the same time, there was a trend for the proportion of cases treated, compared to those referred, that decreased over time (P = 0.051). Overall, among 84 townships, the contribution of CBTC to total case detection deceased from 6% to 4% over time (P < 0.001).
  
  
  CONCLUSIONS
  Contrary to expectations and evidence from previous studies in other countries, a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years. This suggests that measures to support the volunteer network and improve its performance are needed. They may include discussion with local NGOs human resources personnel, incentives for the volunteers, closer supervision of volunteers and improved monitoring and evaluation tools.
authors.affiliation: National Tuberculosis Programme, Ministry of Health and Sports, Zabuthiri township, Postcode 15011, Nay Pyi Taw, Myanmar. htetmyetwinmaung@gmail.com.
authors.forename: Htet Myet Win
authors.initials: HM
authors.lastname: Maung
authors.affiliation: Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar.
authors.forename: Saw
authors.initials: S
authors.lastname: Saw
authors.affiliation: Médecins Sans Frontières, Operational Research Unit, MSF-Luxembourg, Luxembourg, Luxembourg.
authors.forename: Petros
authors.initials: P
authors.lastname: Isaakidis
authors.affiliation: Médecins Sans Frontières, Operational Research Unit, MSF-Luxembourg, Luxembourg, Luxembourg.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khogali
authors.affiliation: Médecins Sans Frontières, Operational Research Unit, MSF-Luxembourg, Luxembourg, Luxembourg.
authors.forename: Anthony
authors.initials: A
authors.lastname: Reid
authors.affiliation: National Tuberculosis Programme, Hanoi, Vietnam.|Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Nguyen Binh
authors.initials: NB
authors.lastname: Hoa
authors.affiliation: Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar.
authors.forename: Ko Ko
authors.initials: KK
authors.lastname: Zaw
authors.affiliation: National Tuberculosis Programme, Ministry of Health and Sports, Zabuthiri township, Postcode 15011, Nay Pyi Taw, Myanmar.
authors.forename: Saw
authors.initials: S
authors.lastname: Thein
authors.affiliation: National Tuberculosis Programme, Ministry of Health and Sports, Zabuthiri township, Postcode 15011, Nay Pyi Taw, Myanmar.
authors.forename: Si Thu
authors.initials: ST
authors.lastname: Aung
mesh_terms: D003140:Communicable Disease Control / Q000458:organization & administration*; D018672:Community Health Planning / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D019058:Community Networks; D037921:Gift Giving; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration; D002052:Myanmar / Q000453:epidemiology; D009874:Operations Research; D009938:Organizations / Q000458:organization & administration*; D012111:Residence Characteristics; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*
keywords: Community based tuberculosis care; Contribution; Operational research; SORT IT