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

Biermann, Olivia, Lönnroth, Knut, Caws, Maxine ORCID: and Viney, Kerri (2019) 'Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review'. BMJ Open, Vol 9, Issue 12, e031284.

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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.

Item Type: Article
Subjects: QS Anatomy > QS 4 General works. Classify here works on regional anatomy
WA Public Health > WA 4 Works on general hygiene
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Marie Hatton
Date Deposited: 16 Dec 2019 11:02
Last Modified: 16 Dec 2019 11:02


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