Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

Objective To explore antecedents, components and influencing factors on active case-finding (ACF) policy development and implementation.Design Scoping review, searching MEDLINE, Web of Science, the Cochrane Database of Systematic Reviews and the World Health Organization (WHO) Library from January 1...

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Main Authors: Olivia Biermann, Knut Lönnroth, Maxine Caws
Format: Article
Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/12/e031284.full
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author Olivia Biermann
Knut Lönnroth
Maxine Caws
author_facet Olivia Biermann
Knut Lönnroth
Maxine Caws
author_sort Olivia Biermann
collection DOAJ
description Objective To explore antecedents, components and influencing factors on active case-finding (ACF) policy development and implementation.Design Scoping review, searching MEDLINE, Web of Science, the Cochrane Database of Systematic Reviews and the World Health Organization (WHO) Library from January 1968 to January 2018. We excluded studies focusing on latent tuberculosis (TB) infection, passive case-finding, childhood TB and studies about effectiveness, yield, accuracy and impact without descriptions of how this evidence has/could influence ACF policy or implementation. We included any type of study written in English, and conducted frequency and thematic analyses.Results Seventy-three articles fulfilled our eligibility criteria. Most (67%) were published after 2010. The studies were conducted in all WHO regions, but primarily in Africa (22%), Europe (23%) and the Western-Pacific region (12%). Forty-one percent of the studies were classified as quantitative, followed by reviews (22%) and qualitative studies (12%). Most articles focused on ACF for tuberculosis contacts (25%) or migrants (32%). Fourteen percent of the articles described community-based screening of high-risk populations. Fifty-nine percent of studies reported influencing factors for ACF implementation; mostly linked to the health system (eg, resources) and the community/individual (eg, social determinants of health). Only two articles highlighted factors influencing ACF policy development (eg, politics). Six articles described WHO’s ACF-related recommendations as important antecedent for ACF. Key components of successful ACF implementation include health system capacity, mechanisms for integration, education and collaboration for ACF.Conclusion We identified some main themes regarding the antecedents, components and influencing factors for ACF policy development and implementation. While we know much about facilitators and barriers for ACF policy implementation, we know less about how to strengthen those facilitators and how to overcome those barriers. A major knowledge gap remains when it comes to understanding which contextual factors influence ACF policy development. Research is required to understand, inform and improve ACF policy development and implementation.
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spelling doaj-art-ef14e937e0354555b78b4c1c1fbce3ba2024-12-03T09:45:10ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-031284Factors influencing active tuberculosis case-finding policy development and implementation: a scoping reviewOlivia Biermann0Knut Lönnroth1Maxine Caws2Department of Global Public Health, Karolinska Institutet, Stockholm, SwedenDepartment of Global Public Health, Karolinska Institute, Stockholm, SwedenBirat Nepal Medical Trust, Kathmandu, NepalObjective To explore antecedents, components and influencing factors on active case-finding (ACF) policy development and implementation.Design Scoping review, searching MEDLINE, Web of Science, the Cochrane Database of Systematic Reviews and the World Health Organization (WHO) Library from January 1968 to January 2018. We excluded studies focusing on latent tuberculosis (TB) infection, passive case-finding, childhood TB and studies about effectiveness, yield, accuracy and impact without descriptions of how this evidence has/could influence ACF policy or implementation. We included any type of study written in English, and conducted frequency and thematic analyses.Results Seventy-three articles fulfilled our eligibility criteria. Most (67%) were published after 2010. The studies were conducted in all WHO regions, but primarily in Africa (22%), Europe (23%) and the Western-Pacific region (12%). Forty-one percent of the studies were classified as quantitative, followed by reviews (22%) and qualitative studies (12%). Most articles focused on ACF for tuberculosis contacts (25%) or migrants (32%). Fourteen percent of the articles described community-based screening of high-risk populations. Fifty-nine percent of studies reported influencing factors for ACF implementation; mostly linked to the health system (eg, resources) and the community/individual (eg, social determinants of health). Only two articles highlighted factors influencing ACF policy development (eg, politics). Six articles described WHO’s ACF-related recommendations as important antecedent for ACF. Key components of successful ACF implementation include health system capacity, mechanisms for integration, education and collaboration for ACF.Conclusion We identified some main themes regarding the antecedents, components and influencing factors for ACF policy development and implementation. While we know much about facilitators and barriers for ACF policy implementation, we know less about how to strengthen those facilitators and how to overcome those barriers. A major knowledge gap remains when it comes to understanding which contextual factors influence ACF policy development. Research is required to understand, inform and improve ACF policy development and implementation.https://bmjopen.bmj.com/content/9/12/e031284.full
spellingShingle Olivia Biermann
Knut Lönnroth
Maxine Caws
Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review
BMJ Open
title Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review
title_full Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review
title_fullStr Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review
title_full_unstemmed Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review
title_short Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review
title_sort factors influencing active tuberculosis case finding policy development and implementation a scoping review
url https://bmjopen.bmj.com/content/9/12/e031284.full
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