{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:31:38Z","timestamp":1787729498883,"version":"build-2784847793"},"reference-count":35,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2025,9,10]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Rajasthan in India, is a high TB burden state with a high prevalence to notification ratio. This gap calls for alternative strategies to find the non-notified people with TB. Because cough is the most prominent symptom of TB and cough syrups are one of the highest over the counter drugs in India, its sale might be used as a proxy for missed TB cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was an ecological study to assess the correlation between cough syrup sales and missed TB notifications in the private sector. We calculated the missed TB notification rate as the difference between the estimated people on TB treatment and TB notification in the private sector from January 2021 to March 2023, across all districts of Rajasthan (n = 33). We analysed district level mean quarterly cough syrup sales and TB notification rates\/100,000 population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We found positive correlation between cough syrup sales and TB notification [overall (r = 0.43), private (r = 0.63) and missed private TB notification (r = 0.39)]. Based on this analysis, missed TB notification rates were 7x more than the reported notifications in the private sector.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>We recommend a private sector-based TB surveillance system with TB screening for people who approach pharmacies for cough syrup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/pha.25.0033","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T04:31:22Z","timestamp":1764909082000},"page":"164-168","source":"Crossref","is-referenced-by-count":2,"title":["Can high private cough syrup sales act as a proxy for missed TB notifications in TB surveillance?"],"prefix":"10.5588","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2382-5323","authenticated-orcid":true,"given":"K.","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.D.","family":"Shewade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Manickam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Soni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.N.","family":"Baig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Dagar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Parmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Saxena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Charan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Abdullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.K.","family":"Bhardwaj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"2026011409295889000_15.4.164.1","unstructured":"World Health Organization . Global TB report 2024. Geneva: WHO, 2024."},{"key":"2026011409295889000_15.4.164.2","unstructured":"Indian Council of Medical Research . Summary Report, National TB Prevalence survey, India, 2019\u20132021. 2021."},{"key":"2026011409295889000_15.4.164.3","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1186\/s12879-019-4169-y","article-title":"Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data","volume":"19","author":"Arinaminpathy","year":"2019","journal-title":"BMC Infect Dis"},{"issue":"12","key":"2026011409295889000_15.4.164.4","doi-asserted-by":"crossref","first-page":"e003835","DOI":"10.1136\/bmjgh-2020-003835","article-title":"Finding the missing millions: lessons from 10 active case finding interventions in high tuberculosis burden countries","volume":"5","author":"Pande","year":"2020","journal-title":"BMJ Glob Heal"},{"key":"2026011409295889000_15.4.164.5","unstructured":"Ministry of Health and Family Welfare . Government of India. National Strategic Plan for Tuberculosis (2017-25). New Delhi: 2017."},{"key":"2026011409295889000_15.4.164.6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.ijtb.2021.04.005","article-title":"Trends and sub-national disparities in TB notifications in India: Insights from HMIS data","volume":"69","author":"Golandaj","year":"2022","journal-title":"Indian J Tuberc"},{"key":"2026011409295889000_15.4.164.7","unstructured":"Central TB Division GOI . India TB Report 2024. 2024."},{"issue":"5","key":"2026011409295889000_15.4.164.8","doi-asserted-by":"crossref","first-page":"265","DOI":"10.3390\/tropicalmed8050265","article-title":"Engaging the Private Health Service Delivery Sector for TB Care in India-Miles to Go","volume":"88","author":"Suseela","year":"2023","journal-title":"Trop Med Infect Dis"},{"key":"2026011409295889000_15.4.164.9","doi-asserted-by":"crossref","first-page":"e29141","DOI":"10.1002\/jmv.29141","article-title":"Differential diagnosis of fever and rash cases negative for measles and rubella to complement surveillance activities","volume":"95","author":"Fappani","year":"2023","journal-title":"J Med Virol"},{"key":"2026011409295889000_15.4.164.10","doi-asserted-by":"crossref","first-page":"20503121241240507","DOI":"10.1177\/20503121241240507","article-title":"Self-medication prevalence and associated factors among adult population in Northern India: A community-based cross-sectional study","volume":"12","author":"Juneja","year":"2024","journal-title":"SAGE Open Med"},{"key":"2026011409295889000_15.4.164.11","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5588\/ijtld.23.0312","article-title":"Measuring cough-related quality of life and cough frequency in pulmonary TB","volume":"28","author":"Turner","year":"2024","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026011409295889000_15.4.164.12","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.18549\/PharmPract.2021.2.2269","article-title":"The competency of Indonesian pharmacy students in handling a self-medication request for a cough: a simulated patient study","volume":"19","author":"Brata","year":"2021","journal-title":"Pharm Pract (Granada)"},{"key":"2026011409295889000_15.4.164.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.11.018"},{"key":"2026011409295889000_15.4.164.14","unstructured":"Government of Rajasthan . Districts https:\/\/rajasthan.gov.in\/pages\/sm\/department-page\/142679\/878"},{"key":"2026011409295889000_15.4.164.15","unstructured":"English jagran . Rajasthan gets new 17 new districts. https:\/\/www.jagran.com\/rajasthan\/jaipur-rajasthan-gets-17-new-districts-cm-ashok-gehlot-virtually-unveiling-plaque-inauguration-23494273.html"},{"key":"2026011409295889000_15.4.164.16","unstructured":"Cambridge dictionary . Cough syrup https:\/\/dictionary.cambridge.org\/dictionary\/english\/cough-syrup"},{"key":"2026011409295889000_15.4.164.17","unstructured":"Census organization of India . Population Census:https:\/\/www.census2011.co.in\/search.php?cx=partner-pub-0612465356921996%3A9964620645&cof=FORID%3A10&ie=UTF-8&q=rajasthan&sa=Search"},{"key":"2026011409295889000_15.4.164.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-060197"},{"key":"2026011409295889000_15.4.164.19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0024160"},{"key":"2026011409295889000_15.4.164.20","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ijtb.2020.01.004","article-title":"Awareness & utilization of NIKSHAY and perceived barriers for tuberculosis case notification among the private practitioners in Udupi district, Karnataka","volume":"67","author":"Dey","year":"2020","journal-title":"Indian J Tuberc"},{"key":"2026011409295889000_15.4.164.21","doi-asserted-by":"crossref","first-page":"136","DOI":"10.4103\/ijph.ijph_1275_22","article-title":"A mixed method study to assess notification of tuberculosis patients by private practitioners in New Delhi, India","volume":"67","author":"Agarwalla","year":"2023","journal-title":"Indian J Public Health"},{"key":"2026011409295889000_15.4.164.22","doi-asserted-by":"crossref","unstructured":"Viney V . To investigate the knowledge, attitude and practices regarding tuberculosis case notification among public and private doctors practicing of modern medicine in South Delhi. Monaldi Arch Chest Dis. 2022;93(2):https:\/\/doi.org\/10.4081\/monaldi.2022.2374.","DOI":"10.4081\/monaldi.2022.2374"},{"key":"2026011409295889000_15.4.164.23","doi-asserted-by":"crossref","unstructured":"Yeole RD , Tuberculosis case notification by private practitioners in Pune, India: how well are we doing? 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TB Free Himachal Campaign. 2018."},{"key":"2026011409295889000_15.4.164.30","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s40249-017-0276-4","article-title":"Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Dar es Salaam, Tanzania","volume":"6","author":"Said","year":"2017","journal-title":"Infect Dis poverty"},{"key":"2026011409295889000_15.4.164.31","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.2147\/RMHP.S367998","article-title":"Duration and Determinants of Delayed Diagnosis with Tuberculosis in Shenzhen, China: A Cross-Sectional Study","volume":"15","author":"Jiang","year":"2022","journal-title":"Risk Manag Healthc Policy"},{"key":"2026011409295889000_15.4.164.32","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-017-0551-y"},{"key":"2026011409295889000_15.4.164.33","doi-asserted-by":"crossref","first-page":"e001417","DOI":"10.1136\/bmjgh-2019-001417","article-title":"Can community pharmacists improve tuberculosis case finding? 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