FEASIBILITY OF INVOLVING LITERATE TRIBAL YOUTHS IN TUBERCULOSIS CASE-FINDING IN A TRIBAL AREA IN TAMIL-NADU

Setting: Tribal area in South India with a population of 96 000, where tuberculosis case-finding activity was very poor. Objectives: To inve stigate the feasibility of (1) involving literate (who can read and wr ite) tribal youth volunteers for detecting cases of pulmonary tubercul osis (PT) in their respective hamlets; and (2) antituberculosis drug d elivery to sputum-positive patients at their homes by village health n urses (VHNs).Design: One volunteer from each of 61 hamlets was selecte d and trained in the detection of subjects with chest symptoms, sputum collection and transportation to the Primary Health Centre for smear examination. All smear-positive patients were treated with 2RHZ/6TH an d the drugs were supplied by VHNs fortnightly at their homes. Results: During a period of 1 year (1992-93), the total population screened wa s 9383 persons; of these 5755 were aged 15 years and above. A total of 338 symptomatic subjects were identified; 12 sputum-positive cases we re detected and started on treatment. Antituberculosis drugs were supp lied by VHNs to patients for the first 9 months of the study and by li terate youths for the next 3 months. Spot drug checks revealed that 11 of the 12 patients were regular in drug consumption. Conclusion: It i s feasible to train literate tribal youth volunteers within a short ti me to detect subjects with chest symptoms in the community and thereby cases of pulmonary tuberculosis. They can serve as an excellent model for community participation in difficult areas.