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APHA Scientific Session and Event Listing

Recorded presentation

Alka Dev, Doctors of the World-USA, 375 W. Broadway, New York, NY 10012, 1-212-226-9890, alka.dev@dowusa.org

Purpose: Doctors of the World-USA (DOW) implemented a two-year project to strengthen the national TB program in Romania. The project focused on implementation of the Directly Observed Therapy Shortcourse (DOTS) strategy in Roma communities. Romania has the largest Roma population in Europe; in addition to greater poverty and long-term experience of human rights abuses, Roma communities are ten times more vulnerable to TB than the Romanian average.

Methods/Results: The project created networks of stakeholders committed to improving Roma health and TB outcomes. Following a survey revealing poor TB knowledge in Roma, DOW trained forty Roma community members as Peer Health Educators to provide community based education on TB, identify potential cases, and encourage defaulters to complete therapy. PHEs carried out 480 education sessions, reaching 13,000 people in three months. Through PHE education sessions, 607 Roma community members exhibiting symptoms were tested for TB; 49 were positive. Over 450 contacts were identified and tested. PHEs provided DOT for 28 patients and provided additional treatment completion support for 69 people. The PHEs liaised between the health system and Roma community members to improve Roma access to TB care.

Conclusions: TB treatment for marginalized populations can be provided at the community level; greater involvement of community members is a low-cost, high-yield strategy to strengthen TB control programs addressing a community with high TB rates. Involving members of marginalized communities in programs is an effective way to address historic violations of their rights to health information, education and access while advancing public health goals.

Learning Objectives:

• Attendees will discuss a model for community DOTS that is being implemented with a population that is consistently marginalized within the health system. Participants will be able to evaluate aspects that lead to successful TB control at the community level and discuss how the model can be adapted for other settings.

Keywords: Tuberculosis, Access to Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation