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APHA Scientific Session and Event Listing

Recorded presentation

Charles Sherman, MD MPH, Medicine, Brown University School of Medicine, 450 VeteransīMemorial Parkway, East Providence, RI 02914, 401-435-5533, cbsherman@gmail.com, Barbara R. Gottlieb, MD, MPH, Brookside Community Health Center, 3297 Washington Street, Jamaica Plain, MA 02130, and N. Susan Hammerton, NP, San Lucas Toliman, Colonia Santo Tomas, San Lucas Toliman, 07013, Guatemala.

The World Health Organization has established standards for tuberculosis surveillance that can be implemented by a variety of health systems in resource-poor settings. Healthcare personnel have dual roles-as providers who identify patients who have persistent unexplained cough and set in motion a series of steps to establish a diagnosis of tuberculosis, and a public health role-to ensure that appropriate treatment is begun, monitored and completed. We implemented a tuberculosis program following these standards in a rural Guatemalan region using the infrastructure of a health promoter program. Mission San Lucas (Toliman) has a greater than 30 year history of engaging with the local community to improve health and economic status. In recent years,a program of health promoters has been established in which individuals in 16 communities with distinct identities have undergone training in health assessment, treatment and prevention using WHO and other guidelines for health promoters. We trained a group of 16 health promoters to conduct surveillance for tuberculosis and other more common respiratory illnesses using 6 questions (cough greater than one month, fever, blood in sputum, weight loss, personal history of TB, family member with TB). Promoters were taught to follow a diagnostic algorithm using sputum collection, treatment for common respiratory illnesses and appropriate follow-up. Senior health promoters learned to prepare and fix slides for AFB staining. The health promoter system has been meshed with the local Centro de Salud and other governmental programs that are in place for treatment. Our program has been in place for one year. We will present our methods for health promoter training and results of one year of community surveillance efforts. We believe that our program can be a model for other resource-poor countries that rely on health promoters and where governmental programs for surveillance and outreach for tuberculosis are lacking.

Learning Objectives:

• Participants will learn the WHO standards for TB surveillance, treatment and follow-up and how they can be applied in a resource-poor setting
• Participants will learn how to develop and implement a training for low to medium literacy level health promoters
• Participants will learn how to mesh a system of health promoters who have access to remote communities with a governmental program that lacks resources for outreach and surveillance

Keywords: Latin American, Tuberculosis

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation