An explanatory mixed-method study to unearth the cascade of events of implementation and coverage challenges of Tuberculosis Preventive Treatment in two Tribal-Dominant Districts of Central India

An explanatory mixed-method study to unearth the cascade of events of implementation and coverage challenges of Tuberculosis Preventive Treatment in two Tribal-Dominant Districts of Central India | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 5 August 2025 V1 Latest version Share on An explanatory mixed-method study to unearth the cascade of events of implementation and coverage challenges of Tuberculosis Preventive Treatment in two Tribal-Dominant Districts of Central India Authors : Manjula Singh , Akash Ranjan Singh [email protected] , Vikrant Kabirpanthi , Somi Soni , Amber Kumar , Sanjeev Bakshi , Digvesh Kumar Patel 0000-0001-5742-9287 , and Manjeet Singh Chalga Authors Info & Affiliations https://doi.org/10.22541/au.175441160.07405730/v1 195 views 81 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective: To estimate the coverage and adherence of Tuberculosis Preventive Treatment (TPT) among eligible House-hold child contact (HHCC) of <5 Years (January–June 2022) in two resource-constraint districts of India. It also explores health system and beneficiary-related barriers related to TP in detail. Methods: This explanatory type of mixed-method study design included a quantitative phase to estimate TPT coverage and followed by a qualitative phase to explore health system’s challenges and beneficiary-related barriers. Coverage was estimated by initiation rate and adherence by completion rate. The respondents for quantitative phase were 320 HHCC and for qualitative phase were eight stakeholder’s interviews, which were conducted between November 2022 and March 2023. Results: Quantitative Phase; From 594 notified persons with TB, 320 HHCC were identified, all eligible for TPT. Initiation rate was 17.5%, completion 9.7%. Among non-initiators, 91% were uninformed, 8% found TPT unnecessary. Total 7% were lost to follow-up due to incomplete 6-month supply. Poor initiation was linked to Anuppur TB Units, staff experience and lack of home visits. Qualitative Phase; Key challenges of health system were lack of home visits and training, Nikshay portal related issues and poor acceptance of TPT. Beneficiary related barriers were hesitancy, migration and TPT supply disruptions. Conclusion: TPT coverage and adherence were very low; main reasons were lack of home visits and limited staff experience. Key beneficiary related barriers were poor communication, perception that TPT is unnecessary, hesitancy, migration, and TPT supply disruptions. Health system’s challenges were poor understanding of rationale of TPT and inadequate supervision. Supplementary Material File (figure 1_v2.pptx) Download 339.86 KB File (figure 2_v2.pptx) Download 112.92 KB File (figure 3_v3.pptx) Download 49.75 KB File (manuscript_v8.docx) Download 652.28 KB Information & Authors Information Version history V1 Version 1 05 August 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords health system challenges of tpt and patient-level barriers of tpt tribal-dominants and resource-constrained districts tuberculosis preventive treatment coverage Authors Affiliations Manjula Singh Indian Council of Medical Research View all articles by this author Akash Ranjan Singh [email protected] Birsa Munda Government Medical College View all articles by this author Vikrant Kabirpanthi Birsa Munda Government Medical College View all articles by this author Somi Soni Birsa Munda Government Medical College View all articles by this author Amber Kumar All India Institute of Medical Science Bhopal View all articles by this author Sanjeev Bakshi Indira Gandhi National Tribal University View all articles by this author Digvesh Kumar Patel 0000-0001-5742-9287 Indira Gandhi National Tribal University View all articles by this author Manjeet Singh Chalga Indian Council of Medical Research View all articles by this author Metrics & Citations Metrics Article Usage 195 views 81 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Manjula Singh, Akash Ranjan Singh, Vikrant Kabirpanthi, et al. An explanatory mixed-method study to unearth the cascade of events of implementation and coverage challenges of Tuberculosis Preventive Treatment in two Tribal-Dominant Districts of Central India. Authorea . 05 August 2025. DOI: https://doi.org/10.22541/au.175441160.07405730/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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