Tuberculosis, the main cause of adult infectious death in the world, requires the examination of several sputum samples for diagnosis and patients need to visit services several times. Patients can only initiate treatment if they have been diagnosed and improving the efficiency of the process is crucial to increasing treatment access. More efficient diagnostic approaches that examine a reduced number of specimens or accelerate their collection to a single day are being developed with support from the World Health Organisation.
This study will assess whether these accelerated approaches could lead to increased access to treatment. The study will aim to identify barriers preventing adults from completing the diagnostic process in Nepal, Yemen and Ethiopia and the changes that are required to increase treatment uptake. A combination of quantitative and qualitative methods will be used, including surveillance data collection and surveys to monitor the proportion of patients initiating and completing treatment, and in depth interviews, focus group discussions and case studies to provide an insight into these processes. Services will be modified in response to the research findings to promote equitable and increased access to health services for under-served populations.