Strengthening TB care pathways

Integrating informal and Ayush practitioners for early diagnosis and referral

Datos Bibliográficos

ID19593551
AutoresRidhima Sodhi (0000-0003-2401-1065, Clinton Foundation), Shruti Goel (0009-0005-8018-339X, Clinton Foundation), Rohit Baghel (0009-0005-5231-0531, Clinton Foundation), Kiran Rade (0000-0001-7601-0780, United Nations Office for Project Services), Kshitij Khaparde (0000-0002-1001-6001, World Health Organization - India), Harkesh Dabas (0009-0006-0219-3282, Clinton Foundation), Shamim Mannan (0000-0002-4530-0694, Clinton Foundation), Manoj Kumar Singh (0000-0001-6800-3548, Clinton Foundation), Manoj Singh (0000-0003-3694-1307)
EditoresJulia Robinson (0000-0003-0719-3995)
Año2026
Volumen6
Número4
Páginase0004416
Fecha de publicación2026-04-08
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaPLOS Global Public Health (JOURNAL)
Identificadores de la revistaISSN: 2767-3375 • E-ISSN: 2767-3375
EditorialPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0004416
PMID41950250
OpenAlexW7151835651
IdiomaEN
Referencias citadas46

Tuberculosis (TB) continues to be the leading cause of death from infectious diseases, disproportionately affecting populations in low- and middle-income countries, where diagnostic and financial barriers impede timely care. While alternative treatments may offer symptomatic relief, the cornerstone of TB management remains anti-tubercular therapy (ATT) as recommended by the World Health Organization (WHO). Yet, many individuals with TB-like symptoms first consult traditional healers and AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy) practitioners, resulting in delays in diagnosis and treatment initiation. This quasi-experimental study evaluated the impact of strengthening linkages between non-allopathic and allopathic providers, through formal referral systems, alongside the implementation of a free chest X-ray (CXR) screening system for presumptive TB patients. A mixed methods design found the significant role of friends and family in influencing care-seeking patterns, while a regression analysis within a Difference-in-Differences approach found the intervention to reduce diagnostic delay by over eight days (-8.6, 95% CI: −16.6, −0.5). The accelerated pathway to diagnosis was observed irrespective of which provider was first visited by the patient, holding promise for future such interventions, especially in high-burden regions, with significant reliance on informal providers

Cornerstone · Health care · Intervention (counseling) · Patient referral · Primary care · Referral · Antibiotic Use and Resistance · Complementary and Alternative Medicine Studies · Tuberculosis Research and Epidemiology