{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T09:28:28Z","timestamp":1780824508831,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,16]],"date-time":"2018-04-16T00:00:00Z","timestamp":1523836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Partners in Health, Liberia"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In June 2015, Partners in Health (<jats:styled-content style=\"fixed-case\">PIH<\/jats:styled-content>) and the Liberian Ministry of Health began a community health worker (<jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content>) programme containing food support, reimbursement of transport and social assistance to address gaps in tuberculosis (<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>) treatment exacerbated by the 2014\u20102015 Ebola virus disease (<jats:styled-content style=\"fixed-case\">EVD<\/jats:styled-content>) epidemic. The purpose of this article was to analyse the performance of routine clinical <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> care and the effects of this <jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content> programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study utilising data from <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patient registers at a census of all health facilities treating <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> in the south\u2010east region of Liberia from January 2015 \u2013 April 2017. Competing risks Cox regression analyses were used to generate subhazard ratios (<jats:styled-content style=\"fixed-case\">sHR<\/jats:styled-content>) analysing factors associated with rates of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> cure (smear negative), treatment completion (no smear), lost to follow\u2010up (<jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>) and death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content> rates decreased 76% pre\u2010 <jats:italic>vs<\/jats:italic>. post\u2010<jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content> intervention, from 14.6% in pre\u2010intervention to 3.4% post\u2010intervention (<jats:italic>P<\/jats:italic> &lt; 0.001). Although the post\u2010intervention had better cure rates (<jats:styled-content style=\"fixed-case\">sHR<\/jats:styled-content> 1.07, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.58\u20101.9), treatment completion (<jats:styled-content style=\"fixed-case\">sHR<\/jats:styled-content> 1.53, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.00 2.39) and lower death rates (<jats:styled-content style=\"fixed-case\">sHR<\/jats:styled-content> 0.64, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.34\u20101.2), statistical significance was not reached. Younger patients had significantly lower death and cure rates, while older patients had higher <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content> and cure rates. Overall, 31% of patients were cured, 44% completed treatment without a confirmatory smear, 5% were <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content>, 9% died, 0.5% failed treatment, and 10% transferred out.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In challenging environments, <jats:styled-content style=\"fixed-case\">LTFU<\/jats:styled-content> can be reduced by <jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content> accompaniment and socio\u2010economic assistance to patients with <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>. Approaches are needed to improve cure verification in young patients and reduce mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13049","type":"journal-article","created":{"date-parts":[[2018,3,10]],"date-time":"2018-03-10T04:46:41Z","timestamp":1520657201000},"page":"549-557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment outcomes of <scp>TB<\/scp>\u2010infected individuals attending public sector primary care clinics in rural Liberia from 2015 to 2017: a retrospective cohort study"],"prefix":"10.1111","volume":"23","author":[{"given":"Eugene","family":"Wickett","sequence":"first","affiliation":[{"name":"Partners in Health Monrovia Liberia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Peralta\u2010Santos","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle WA USA"},{"name":"Centro de Investiga\u00e7\u00e3o em Sa\u00fade P\u00fablica Escola Nacional de Sa\u00fade P\u00fablica Universidade Nova de Lisboa Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Beste","sequence":"additional","affiliation":[{"name":"Partners in Health Monrovia Liberia"},{"name":"Brigham and Women's Hospital Boston MA USA"},{"name":"Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Micikas","sequence":"additional","affiliation":[{"name":"Partners in Health Monrovia Liberia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foriest","family":"Toe","sequence":"additional","affiliation":[{"name":"Ministry of Health Monrovia Liberia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Rogers","sequence":"additional","affiliation":[{"name":"Partners in Health Monrovia Liberia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lassana","family":"Jabateh","sequence":"additional","affiliation":[{"name":"Partners in Health Monrovia Liberia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley H.","family":"Wagenaar","sequence":"additional","affiliation":[{"name":"Partners in Health Monrovia Liberia"},{"name":"Department of Global Health University of Washington Seattle WA USA"},{"name":"Health Alliance International Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,16]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization.Global tuberculosis report2016. 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