{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:18:24Z","timestamp":1789773504802,"version":"4.0.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:00:00Z","timestamp":1659484800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>India is the highest TB burden country, accounting for an estimated 26% of the global TB cases. Systematic engagement of the private sector is a cornerstone of India\u2019s National Strategic Plan for TB Elimination (2017\u201325). However, informal healthcare providers (IPs), who are the first point of contact for a large number of TB patients, remain significantly underutilized in the National TB Elimination Program of India. Non-prioritization of IPs has also resulted in a limited understanding of their TB care practices in the community. We, therefore, undertook a descriptive study to document IPs\u2019 TB care practices, primarily focusing on their approach to screening, diagnosis, treatment and referral. This cross-sectional study was carried out from February to March 2020 in the Birbhum District of West Bengal, India. Interviews were conducted utilizing the retrospective case study method. A total of 203 IPs participated who reported seeing at least one confirmed TB patient in 6\u00a0months prior to the study. In that duration, IPs reported interacting with an average of five suspected TB cases, two of which were later confirmed as having TB. Antibiotic use was found to be common among IPs (highest 69% during the first visit); however, they were prescribed before the patient was suspected or confirmed as having TB. We noted the practice of prolonged treatment among IPs as patients were prescribed medicines until the second follow-up visit. Referral was the preferred TB case management approach among IPs, but delayed referral was observed, with only one-third (34%) of patients being referred to higher health facilities during their first visit. This study presents important findings on IPs\u2019 TB care practices, which have consequences for achieving India\u2019s national goal of TB elimination.<\/jats:p>","DOI":"10.1093\/heapol\/czac062","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T14:36:04Z","timestamp":1659537364000},"page":"1158-1166","source":"Crossref","is-referenced-by-count":13,"title":["What are the tuberculosis care practices of informal healthcare providers? A cross-sectional study from Eastern India"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3333-1434","authenticated-orcid":false,"given":"Poshan","family":"Thapa","sequence":"first","affiliation":[{"name":"School of Population Health, University of New South Wales , Sydney 2052, Australia"},{"name":"Department of Public Health and Community Programs\u2014Dhulikhel Hospital, Kathmandu University School of Medical Sciences , Dhulikhel 4520, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9839-5626","authenticated-orcid":false,"given":"John J","family":"Hall","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales , Sydney 2052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3108-2304","authenticated-orcid":false,"given":"Rohan","family":"Jayasuriya","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales , Sydney 2052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6483-5985","authenticated-orcid":false,"given":"Partha Sarathi","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Liver Foundation , Kolkata, West Bengal 700071, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1935-5851","authenticated-orcid":false,"given":"Kristen","family":"Beek","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales , Sydney 2052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0923-3033","authenticated-orcid":false,"given":"Dipesh Kr","family":"Das","sequence":"additional","affiliation":[{"name":"Liver Foundation , Kolkata, West Bengal 700071, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tushar","family":"Mandal","sequence":"additional","affiliation":[{"name":"Liver Foundation , Kolkata, West Bengal 700071, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2020-0865","authenticated-orcid":false,"given":"Padmanesan","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"School of Population Health, University of New South Wales , Sydney 2052, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"2022101216071054600_R1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0071119","article-title":"Tuberculosis management practices by private practitioners in Andhra Pradesh, India","volume":"8","author":"Achanta","year":"2013","journal-title":"PloS One"},{"key":"2022101216071054600_R2","article-title":"Brief guide on tuberculosis control for primary health care providers: for countries in the WHO European region with a high and intermediate burden of tuberculosis","author":"Ahamed","year":"2004"},{"key":"2022101216071054600_R3","doi-asserted-by":"crossref","DOI":"10.4321\/S1886-36552014000200003","article-title":"High prescription of antimicrobials in a rural district hospital in India","volume":"12","author":"Alvarez-Uria","year":"2014","journal-title":"Pharmacy Practice"},{"key":"2022101216071054600_R4","doi-asserted-by":"crossref","first-page":"553","DOI":"10.5588\/09640569513093","article-title":"Knowledge and practice pattern of non-allopathic indigenous medical practitioners regarding tuberculosis in a rural area of India","volume":"6","author":"Anandhi","year":"2002","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"2022101216071054600_R5","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.5588\/ijtld.10.0294","article-title":"Knowledge, attitudes and practices of private sector providers of tuberculosis care: a scoping review","volume":"15","author":"Bell","year":"2011","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"2022101216071054600_R6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0149862","article-title":"How do urban Indian private practitioners diagnose and treat tuberculosis? A cross-sectional study in Chennai","volume":"11","author":"Bronner Murrison","year":"2016","journal-title":"PloS One"},{"key":"2022101216071054600_R7","doi-asserted-by":"crossref","first-page":"544","DOI":"10.5588\/ijtld.15.0423","article-title":"How do patients access the private sector in Chennai, India? An evaluation of delays in tuberculosis diagnosis","volume":"20","author":"Bronner Murrison","year":"2016","journal-title":"The International Journal of Tuberculosis and Lung Disease"},{"key":"2022101216071054600_R8","article-title":"National Strategic Plan for Tuberculosis Elimination 2017\u20132025","author":"Central TB Division","year":"2017"},{"key":"2022101216071054600_R9","article-title":"Guidance document on partnership. Ministry of Health and Family Welfare","author":"Central TB Division","year":"2019"},{"key":"2022101216071054600_R10","article-title":"India TB report 2021","author":"Central TB Division","year":"2021"},{"key":"2022101216071054600_R11","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaf7384","article-title":"The impact of training informal health care providers in India: a randomized controlled trial","volume":"354","author":"Das","year":"2016","journal-title":"Science"},{"key":"2022101216071054600_R12","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/S1473-3099(15)00077-8","article-title":"Use of standardised patients to assess quality of tuberculosis care: a pilot, cross-sectional study","volume":"15","author":"Das","year":"2015","journal-title":"The Lancet Infectious Diseases"},{"key":"2022101216071054600_R13","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0196067","article-title":"Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India","volume":"13","author":"Dutta","year":"2018","journal-title":"PLoS One"},{"key":"2022101216071054600_R14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40545-019-0182-1","article-title":"Need to improve availability of \u2018access\u2019 group antibiotics and reduce the use of \u2018watch\u2019 group antibiotics in India for optimum use of antibiotics to contain antimicrobial resistance","volume":"12","author":"Gandra","year":"2019","journal-title":"Journal of Pharmaceutical Policy and Practice"},{"key":"2022101216071054600_R15","doi-asserted-by":"crossref","first-page":"627","DOI":"10.4103\/0971-5916.90987","article-title":"\u2018First we go to the small doctor\u2019: first contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India","volume":"134","author":"Gautham","year":"2011","journal-title":"The Indian Journal of Medical Research"},{"key":"2022101216071054600_R16","doi-asserted-by":"crossref","first-page":"i20","DOI":"10.1093\/heapol\/czt050","article-title":"Informal rural healthcare providers in North and South India","volume":"29","author":"Gautham","year":"2014","journal-title":"Health Policy and Planning"},{"key":"2022101216071054600_R17","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2021.113813","article-title":"What are the challenges for antibiotic stewardship at the community level? 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