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Protocol for the Ad...
Protocol for the Addressing the Social Determinants and Consequences of Tuberculosis in Nepal (ASCOT) pilot trial
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Rai, B (författare)
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Dixit, K (författare)
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Dhital, R (författare)
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Rishal, P (författare)
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Gurung, SC (författare)
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Paudel, PR (författare)
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Mishra, G (författare)
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Bonnett, L (författare)
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Siqueira-Filha, N (författare)
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Khanal, MN (författare)
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- Lonnroth, K (författare)
- Karolinska Institutet
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Squire, SB (författare)
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Caws, M (författare)
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- Wingfield, T (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2022-12-13
- 2022
- Engelska.
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Ingår i: Wellcome open research. - : F1000 Research Ltd. - 2398-502X. ; 7, s. 141-
- Relaterad länk:
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http://kipublication...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: The World Health Organization’s End TB (tuberculosis) Strategy advocates social and economic support for TB-affected households but evidence from low-income settings is scarce. We will evaluate the feasibility and acceptability of a locally-appropriate socioeconomic support intervention for TB-affected households in Nepal. METHODS: We will conduct a pilot randomised-controlled trial with mixed-methods process evaluation in four TB-endemic, impoverished districts of Nepal: Pyuthan, Chitwan, Mahottari, and Morang. We will recruit 128 people with TB notified to the Nepal National TB Program (NTP) and 40 multisectoral stakeholders including NTP staff, civil-society members, policy-makers, and ASCOT (Addressing the Social Determinants and Consequences of Tuberculosis) team members. People with TB will be randomised 1:1:1:1 to four study arms (n=32 each): control; social support; economic support; and combined social and economic (socioeconomic) support. Social support will be TB education and peer-led mutual-support TB Clubs providing TB education and stigma-reduction counselling. Economic support will be monthly unconditional cash transfers during TB treatment with expectations (not conditions) of meeting NTP goals. At 0, 2, and 6 months following TB treatment initiation, participants will be asked to complete a survey detailing the social determinants and consequences of TB and their feedback on ASCOT. Complementary process evaluation will use focus group discussions (FGD), key informant interviews (KII), and a workshop with multi-sectoral stakeholders to consider the challenges to ASCOT’s implementation and scale-up. A sample of ~100 people with TB is recommended to estimate TB-related costs. Information power is estimated to be reached with approximately 25 FGD and 15 KII participants. CONCLUSIONS: The ASCOT pilot trial will both generate robust evidence on a locally-appropriate, socioeconomic support intervention for TB-affected households in Nepal and inform a large-scale future ASCOT trial, which will evaluate the intervention’s impact on catastrophic costs mitigation and TB outcomes. The trial is registered with the ISRCTN (ISRCTN17025974).
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Rai, B
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Dixit, K
-
Dhital, R
-
Rishal, P
-
Gurung, SC
-
Paudel, PR
-
visa fler...
-
Mishra, G
-
Bonnett, L
-
Siqueira-Filha, ...
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Khanal, MN
-
Lonnroth, K
-
Squire, SB
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Caws, M
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Wingfield, T
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visa färre...
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Wellcome open re ...
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Karolinska Institutet