Cash interventions to improve clinical outcomes for pulmonary tuberculosis: systematic review and meta-analysis.

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pulmonary tuberculosis 11 infectiousdiseases
tuberculosis 112 infectiousdiseases

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HIV seropositivity 16434 delay,[22] or not eligible for the intervention, because of insufficient financial need.[20]Prevalence of HIV seropositivity among the study populations was 0–15% in the six studies reporting the outcome.[15],16.14,[17],[18],[22]
pulmonary tuberculosis 100 Title: Bulletin of the World Health OrganizationCash interventions to improve clinical outcomes for pulmonary tuberculosis : systematic review and meta-analysisDes interventions financières pour améliorer les résultats cliniques
pulmonary tuberculosis 1278 6/2018AbstractAbstractObjectiveTo assess cash transfer interventions for improving treatment outcomes of active pulmonary tuberculosis in low- and middle-income countries.MethodsWe searched PubMed®, Embase®, Cochrane Library and ClinicalTrials.gov
pulmonary tuberculosis 1534 published until 4 August 2017 that reported on cash transfer interventions during the treatment of active pulmonary tuberculosis in low- and middle-income countries. Our primary outcome was a positive clinical outcome, defined as
pulmonary tuberculosis 2775 suggests that patients in low- and middle-income countries receiving cash during treatment for active pulmonary tuberculosis are more likely to have a positive clinical outcome. These findings support the incorporation of cash
pulmonary tuberculosis 5059 interventions. We were especially interested if cash transfer to people receiving treatment for active pulmonary tuberculosis affects their clinical outcomes.MethodsWe followed the Preferred Reporting Items for Systematic Reviews
pulmonary tuberculosis 5375 author.To identify studies on the use of cash transfer interventions during the treatment of active pulmonary tuberculosis in low- and middle-income countries, we searched the online databases PubMed®, Embase®, Cochrane Library
pulmonary tuberculosis 6249 directed at people initiating treatment for microbiologically confirmed or clinically suspected active pulmonary tuberculosis . We used the WHO definition for tuberculosis and the 2017 World Bank’s classification of low- and
pulmonary tuberculosis 14026 20152006–2010Retrospective cohort in Shanghai, ChinaDOTS, free care63100NR0Migrants treated for smear-positive pulmonary tuberculosis living in one of the eight districts providing cashMigrants treated for smear-positive pulmonary tuberculosis
pulmonary tuberculosis 14136 tuberculosis living in one of the eight districts providing cashMigrants treated for smear-positive pulmonary tuberculosis living in one of the nine districts not providing cashUkwaja et al.,[16] 20172014Prospective pre- and
pulmonary tuberculosis 25342 2016Microbiologic cure57881467475211281.07 (1.04–1.11)bAge, ethnicity, diabetes mellitus, HIV, extra pulmonary tuberculosis , self-administered treatment, rural area, number of rooms in house, inappropriate floor material, baseline
pulmonary tuberculosis 33800 found some evidence that cash transfer interventions improve treatment outcomes in patients with active pulmonary tuberculosis in low- and middle-income countries, although the overall quality of this evidence is low. These findings
tuberculosis 110 Bulletin of the World Health OrganizationCash interventions to improve clinical outcomes for pulmonary tuberculosis : systematic review and meta-analysisDes interventions financières pour améliorer les résultats cliniques
tuberculosis 368 systématique et méta-analyseIntervenciones de efectivo para mejorar los resultados clínicos de la tuberculosis pulmonar: revisión sistemática y metanálisis التدخلات النقدية لتحسين النتائج
tuberculosis 981 метаанализAlternative Title: Aaron Richterman et al.Alternative Title: Cash interventions to improve tuberculosis outcomesAaron RichtermanJonathan Steer-MassaroJana JarolimovaLiem Binh Luong NguyenJennifer WerdenbergLouise
tuberculosis 1288 6/2018AbstractAbstractObjectiveTo assess cash transfer interventions for improving treatment outcomes of active pulmonary tuberculosis in low- and middle-income countries.MethodsWe searched PubMed®, Embase®, Cochrane Library and ClinicalTrials.gov
tuberculosis 1544 4 August 2017 that reported on cash transfer interventions during the treatment of active pulmonary tuberculosis in low- and middle-income countries. Our primary outcome was a positive clinical outcome, defined as
tuberculosis 2065 meta-analysis.FindingsEight studies met eligibility criteria for review inclusion. Seven studies assessed a tuberculosis -specific intervention, with average amount of cash ranging from Int$ 193–858. One study assessed
tuberculosis 2180 tuberculosis-specific intervention, with average amount of cash ranging from Int$ 193–858. One study assessed a tuberculosis -sensitive intervention, with average amount of Int$ 101. Four studies included non-cash co-interventions.
tuberculosis 2466 group than the control group. After excluding three studies with high risk of bias, patients receiving tuberculosis -specific cash transfer were more likely to have a positive clinical outcome than patients in the control
tuberculosis 2785 that patients in low- and middle-income countries receiving cash during treatment for active pulmonary tuberculosis are more likely to have a positive clinical outcome. These findings support the incorporation of cash
tuberculosis 2961 findings support the incorporation of cash transfer interventions into social protection schemes within tuberculosis treatment programmes.IntroductionTuberculosis remains one of the top 10 causes of death worldwide, with
tuberculosis 3350 2015, the World Health Organization’s (WHO’s) End TB Strategy set the goal of a 90% reduction in tuberculosis deaths, an 80% reduction in tuberculosis incidence rate and zero catastrophic costs for tuberculosis-affected
tuberculosis 3391 (WHO’s) End TB Strategy set the goal of a 90% reduction in tuberculosis deaths, an 80% reduction in tuberculosis incidence rate and zero catastrophic costs for tuberculosis-affected families by 2030.[3] These goals
tuberculosis 3451 tuberculosis deaths, an 80% reduction in tuberculosis incidence rate and zero catastrophic costs for tuberculosis -affected families by 2030.[3] These goals explicitly acknowledge the need to both directly treat people
tuberculosis 3647 directly treat people infected with the disease and address social determinants of health to improve tuberculosis outcomes.Social protection policies protect individuals or households during periods when they are unable
tuberculosis 4056 by formal institutions, are one form of social protection that has been proposed in the setting of tuberculosis .[5],[6] Such interventions can either be tuberculosis-specific or tuberculosis-sensitive.[6] Tuberculosis-specific
tuberculosis 4110 protection that has been proposed in the setting of tuberculosis.[5],[6] Such interventions can either be tuberculosis -specific or tuberculosis-sensitive.[6] Tuberculosis-specific interventions target directly tuberculosis
tuberculosis 4135 proposed in the setting of tuberculosis.[5],[6] Such interventions can either be tuberculosis-specific or tuberculosis -sensitive.[6] Tuberculosis-specific interventions target directly tuberculosis patients and their households,
tuberculosis 4214 tuberculosis-specific or tuberculosis-sensitive.[6] Tuberculosis-specific interventions target directly tuberculosis patients and their households, and are typically incorporated into existing tuberculosis treatment programmes.[6]
tuberculosis 4303 target directly tuberculosis patients and their households, and are typically incorporated into existing tuberculosis treatment programmes.[6] A tuberculosis-sensitive intervention is part of a broader social protection
tuberculosis 4343 their households, and are typically incorporated into existing tuberculosis treatment programmes.[6] A tuberculosis -sensitive intervention is part of a broader social protection scheme, potentially affecting tuberculosis
tuberculosis 4448 tuberculosis-sensitive intervention is part of a broader social protection scheme, potentially affecting tuberculosis outcomes by targeting communities and groups that are at high risk for tuberculosis. The effect on health
tuberculosis 4532 potentially affecting tuberculosis outcomes by targeting communities and groups that are at high risk for tuberculosis . The effect on health outcomes, cost–effectiveness and feasibility of these two strategies are not
tuberculosis 4822 health-care infrastructure.Since a review in 2011 on the effects of cash transfer interventions on tuberculosis outcomes in low- and middle-income countries was inconclusive,[7] we assessed the current state of the
tuberculosis 5069 interventions. We were especially interested if cash transfer to people receiving treatment for active pulmonary tuberculosis affects their clinical outcomes.MethodsWe followed the Preferred Reporting Items for Systematic Reviews
tuberculosis 5385 identify studies on the use of cash transfer interventions during the treatment of active pulmonary tuberculosis in low- and middle-income countries, we searched the online databases PubMed®, Embase®, Cochrane Library
tuberculosis 6259 people initiating treatment for microbiologically confirmed or clinically suspected active pulmonary tuberculosis . We used the WHO definition for tuberculosis and the 2017 World Bank’s classification of low- and
tuberculosis 6304 microbiologically confirmed or clinically suspected active pulmonary tuberculosis. We used the WHO definition for tuberculosis and the 2017 World Bank’s classification of low- and middle-income countries.[9],[10] We included
tuberculosis 7115 among all authors.Box 1Type of data extracted from identified studies on cash interventions to improve tuberculosis outcomeWe extracted data on location; urban and rural setting; time frame; study design; number of subjects;
tuberculosis 7325 of subjects; age and gender of participants; HIV prevalence; number with microbiologically confirmed tuberculosis ; number with confirmed or suspected MDR and XDR tuberculosis; type of usual care for tuberculosis; annual
tuberculosis 7386 number with microbiologically confirmed tuberculosis; number with confirmed or suspected MDR and XDR tuberculosis ; type of usual care for tuberculosis; annual individual or household income; whether the intervention
tuberculosis 7423 confirmed tuberculosis; number with confirmed or suspected MDR and XDR tuberculosis; type of usual care for tuberculosis ; annual individual or household income; whether the intervention was conditional; tuberculosis-specific
tuberculosis 7518 for tuberculosis; annual individual or household income; whether the intervention was conditional; tuberculosis -specific or sensitive intervention; concurrently implemented co-interventions; primary and secondary
tuberculosis 8268 intervention group was not reported in the article, we contacted the authors to provide the figures.Because tuberculosis disproportionately affects the poorest households within a given context,[12] we estimated the average
tuberculosis 10344 human immunodeficiency (HIV) prevalence, multidrug resistance (MDR) or extensive-drug resistance (XDR) tuberculosis prevalence and World Bank income classification. However, there was not enough information available
tuberculosis 11321 21 976 subjects.Fig. 1Flowchart showing the selection of studies on cash interventions to improve tuberculosis clinical outcomes, 1991–2017Study settings and populationsTable 1 summarizes the settings and populations
tuberculosis 11905 Three of the studies took place in countries currently on the WHO list of high-burden countries for tuberculosis [16],[19],[22],[23] and two other studies were in a country currently considered high burden for MDR
tuberculosis 12018 tuberculosis[16],[19],[22],[23] and two other studies were in a country currently considered high burden for MDR tuberculosis .[15],[21]Table 1Design, setting and population of included studies in the systematic review on cash
tuberculosis 12156 setting and population of included studies in the systematic review on cash interventions to improve tuberculosis clinical outcomes, 1991–2017Author, publication yearYear of studyStudy design and settingUsual care%
tuberculosis 12303 1991–2017Author, publication yearYear of studyStudy design and settingUsual care% male% smear positive% HIV% MDR tuberculosis Intervention groupControl groupTuberculosis-specific interventionsFarmer et al.,[17] 19911989–1990Cluster
tuberculosis 12566 clinic in rural Haiti Free care, no community health workers or DOTS331005NRPeople with newly diagnosed tuberculosis from sector adjacent to clinicPeople with newly diagnosed tuberculosis from outside sector adjacent
tuberculosis 12637 DOTS331005NRPeople with newly diagnosed tuberculosis from sector adjacent to clinicPeople with newly diagnosed tuberculosis from outside sector adjacent to clinicChirico et al.,[20] 20112004–2008Retrospective cohort in one
tuberculosis 12881 Aires, Argentina51% of patients receiving DOTS, cost of care NR57NR60.91All people with newly diagnosed tuberculosis reported to national tuberculosis control programmePeople with newly diagnosed tuberculosis who did
tuberculosis 12915 receiving DOTS, cost of care NR57NR60.91All people with newly diagnosed tuberculosis reported to national tuberculosis control programmePeople with newly diagnosed tuberculosis who did not get the intervention because deemed
tuberculosis 12973 diagnosed tuberculosis reported to national tuberculosis control programmePeople with newly diagnosed tuberculosis who did not get the intervention because deemed not to have the financial need, chosen at random among
tuberculosis 13281 historical control in eight shantytowns in Lima, PeruDOTS, free careNRNRNRNRPeople with newly diagnosed tuberculosis from households in the national tuberculosis programme where intervention had been implementedPeople
tuberculosis 13326 PeruDOTS, free careNRNRNRNRPeople with newly diagnosed tuberculosis from households in the national tuberculosis programme where intervention had been implementedPeople with newly diagnosed tuberculosis from households
tuberculosis 13416 national tuberculosis programme where intervention had been implementedPeople with newly diagnosed tuberculosis from households in the national tuberculosis programme where the intervention had not yet been implementedCiobanu
tuberculosis 13461 intervention had been implementedPeople with newly diagnosed tuberculosis from households in the national tuberculosis programme where the intervention had not yet been implementedCiobanu et al.,[18] 20142008, 2011Nation-wide
tuberculosis 13708 historical control in the Republic of MoldovaDOTS, cost of care NR693630Adults with drug-susceptible tuberculosis registered for treatment in 2011 (after introduction of incentives)Adults with drug-susceptible tuberculosis
tuberculosis 13817 tuberculosis registered for treatment in 2011 (after introduction of incentives)Adults with drug-susceptible tuberculosis registered for treatment in 2008 (before introduction of incentives)Lu et al.,[19] 20152006–2010Retrospective
tuberculosis 14036 20152006–2010Retrospective cohort in Shanghai, ChinaDOTS, free care63100NR0Migrants treated for smear-positive pulmonary tuberculosis living in one of the eight districts providing cashMigrants treated for smear-positive pulmonary tuberculosis
tuberculosis 14146 tuberculosis living in one of the eight districts providing cashMigrants treated for smear-positive pulmonary tuberculosis living in one of the nine districts not providing cashUkwaja et al.,[16] 20172014Prospective pre- and
tuberculosis 14423 in Ebonyi State, NigeriaDOTS, cost of care NR5455150All registered people receiving first-line anti- tuberculosis treatment at study site during 3-month period of interventionAll registered people receiving first-line
tuberculosis 14545 at study site during 3-month period of interventionAll registered people receiving first-line anti- tuberculosis treatment at study site during 3-month period without financial packageWingfield et al.,[15] 20172014–2015Cluster
tuberculosis 14802 thirty-two contiguous shantytowns in Callao, PeruDOTS, free care627059People starting treatment for tuberculosis administered by the national tuberculosis programme, randomized to receive the socioeconomic support
tuberculosis 14844 Callao, PeruDOTS, free care627059People starting treatment for tuberculosis administered by the national tuberculosis programme, randomized to receive the socioeconomic support interventionPeople starting treatment for
tuberculosis 14958 programme, randomized to receive the socioeconomic support interventionPeople starting treatment for tuberculosis administered by the national tuberculosis programme, randomized not to receive the socioeconomic support
tuberculosis 15000 socioeconomic support interventionPeople starting treatment for tuberculosis administered by the national tuberculosis programme, randomized not to receive the socioeconomic support interventionTuberculosis-sensitive interventionsTorrens
tuberculosis 15394 observed therapy if judged to be able to complete treatment50NR70People with newly diagnosed non-MDR tuberculosis recorded in the national database who received cash during treatmentPeople with newly diagnosed non-MDR
tuberculosis 15511 recorded in the national database who received cash during treatmentPeople with newly diagnosed non-MDR tuberculosis recorded in the national database who were eligible for cash interventions, but only started to receive
tuberculosis 15922 migrant workers, a high-risk group within an urban centre.[19] The remaining studies evaluated all tuberculosis patients identified within a given geographic or clinical service area. The control groups were either
tuberculosis 16582 was 0–15% in the six studies reporting the outcome.[15],16.14,[17],[18],[22] Patients with MDR/XDR tuberculosis were excluded from four studies,[16],[18],[19],[22] two studies reported low prevalence (1–9%),[15],[20]
tuberculosis 16796 (1–9%),[15],[20] while two did not report on drug susceptibility.[17],[21] Five studies reported free care for tuberculosis ,[15],[17],[19],[21],[22] with the others not specifically commenting on the cost of care.[16],[18],[20]
tuberculosis 17083 observed therapy, short-course.[24]Tuberculosis-specific interventionsIn total, seven studies evaluated tuberculosis -specific cash transfer interventions (Table 2).[15]–[21] Six of these studies were at least partially
tuberculosis 17541 transfer intervention of included studies in the systematic review on cash interventions to improve tuberculosis clinical outcomes, 1991–2017Author, yearCash transfer interventionConditional intervention; method
tuberculosis 18663 enrolmentNANANANoneRocha et al.,[21] 2011Cash transfers for transportation, poverty reduction, and other tuberculosis -associated costs NRNA29117 (5.5)dMicrocredit loans, vocational training, microenterprise activities
tuberculosis 19509 control253NANANoneUkwaja et al.,[16] 2017Monthly cash transfer equivalent to median direct cost for tuberculosis care. Appointments for tuberculosis patients receiving cash arranged to not coincide with the control
tuberculosis 19545 2017Monthly cash transfer equivalent to median direct cost for tuberculosis care. Appointments for tuberculosis patients receiving cash arranged to not coincide with the control groupYes: clinic visits; cash delivered
tuberculosis 19807 member19319311NoneWingfield et al.,[15] 2017Cash transfers throughout treatment to defray average household tuberculosis -associated costs, estimated to be 10% annual household income in this settingYes: details unspecified;
tuberculosis 19998 settingYes: details unspecified; deposit into bank account43635513 (3.6)dHousehold visits with education on tuberculosis transmission, treatment, and preventive therapy and on household finances. Community meetings for information,
tuberculosis 21372 from Int$ 193–858. Two studies chose the amount of cash based on previous work estimating local tuberculosis -associated household costs,[15],[16] including the CRESIPT project in Peru, the only identified randomized
tuberculosis 21992 psychological intervention.[15],[17],[18],[21]Tuberculosis-sensitive interventionsOnly one study described a tuberculosis -sensitive intervention, a nation-wide retrospective cohort study in Brazil of tuberculosis patients
tuberculosis 22083 described a tuberculosis-sensitive intervention, a nation-wide retrospective cohort study in Brazil of tuberculosis patients in the Bolsa Familia programme. The programme is a monthly cash transfer to poor people that
tuberculosis 22379 their children and that their young children attend school.[22] People with newly diagnosed non-MDR tuberculosis who received cash during treatment were compared to those who were eligible for cash at the time of
tuberculosis 23401 groups.[15]–[18]Table 3Outcomes of included studies in the systematic review on cash interventions to improve tuberculosis clinical outcomes, 1991–2017Author, yearPrimary outcomeOutcome indicatoraSample sizeNo. patients of
tuberculosis 24223 (1.65–6.51)NoneHealth insurance registration (98% vs 36%); contact screening (96% vs 82%); rapid MDR- tuberculosis testing (92% vs 67%); HIV testing (97% vs 31%); contact preventive therapy initiation (88% vs 39%) and
tuberculosis 24507 success23782492208119642.00 (1.61–2.22)bPlace of residence, sex, age, occupation, homelessness, HIV, type of tuberculosis Treatment failure (2% vs 5%); loss to follow-up (5% vs 10%); death (5% vs 6%)Lu et al.,[19] 2015Treatment
tuberculosis 24739 success32902413NRNR1.65 (1.40–1.95)bGender, age, occupation, per capita GDP of district, density of population, tuberculosis specialists per 100 patientsNoneUkwaja et al.,[16] 2017Treatment success1211731041232.30 (1.20–4.30)bSex,
tuberculosis 24911 2017Treatment success1211731041232.30 (1.20–4.30)bSex, age, rural/urban residence, new/previously treated tuberculosis , HIV, smear-positivityLoss to follow-up (5% vs 20%); transferred out (1% vs 0%); death (7% vs 6%); smear
tuberculosis 25352 2016Microbiologic cure57881467475211281.07 (1.04–1.11)bAge, ethnicity, diabetes mellitus, HIV, extrapulmonary tuberculosis , self-administered treatment, rural area, number of rooms in house, inappropriate floor material, baseline
tuberculosis 26624 4Bias within included observational studies in the systematic review on cash interventions to improve tuberculosis clinical outcomes, 1991–2017Study, yearCategory, no. of starsSelectionaComparabilitybOutcomecFarmer
tuberculosis 27354 bias.Fig. 2Publication bias of studies included in the meta-analysis on cash interventions to improve tuberculosis clinical outcomes, 1991–2017OR: odds ratio; SE: standard error.Note: The dashed vertical line represents
tuberculosis 27606 random effects meta-analysis.Summary effect measuresFig. 3 shows the forest plot of the remaining tuberculosis -specific studies after excluding studies at high overall risk of bias. Patients receiving tuberculosis-specific
tuberculosis 27709 tuberculosis-specific studies after excluding studies at high overall risk of bias. Patients receiving tuberculosis -specific cash transfer were more likely to have a clinical positive outcome than patients in the control
tuberculosis 27976 1.57–2.01), with I2 = 0% (Q test P = 0.44).Fig. 3Likelihood of a positive clinical outcome for tuberculosis -specific cash interventions to improve tuberculosis clinical outcomes, 1991–2017CI: confidence interval;
tuberculosis 28028 3Likelihood of a positive clinical outcome for tuberculosis-specific cash interventions to improve tuberculosis clinical outcomes, 1991–2017CI: confidence interval; OR: odds ratio.Note: We excluded three studies
tuberculosis 28358 suggest that cash transfer interventions for patients in low- and middle-income countries initiating tuberculosis treatment may improve clinical outcomes. All studies reported improvement in treatment outcomes. However,
tuberculosis 28869 several possible mechanisms by which cash transfer interventions may improve clinical outcomes for tuberculosis patients during treatment.[6],[25] Both tuberculosis-specific and tuberculosis-sensitive cash transfer
tuberculosis 28922 interventions may improve clinical outcomes for tuberculosis patients during treatment.[6],[25] Both tuberculosis -specific and tuberculosis-sensitive cash transfer interventions can act as direct poverty-reduction
tuberculosis 28948 clinical outcomes for tuberculosis patients during treatment.[6],[25] Both tuberculosis-specific and tuberculosis -sensitive cash transfer interventions can act as direct poverty-reduction measures by offsetting costs
tuberculosis 29301 well as indirect costs incurred through loss of wages. In particular, catastrophic costs, defined as tuberculosis -related costs which exceed 20% of the household’s annual income, have been associated with adverse
tuberculosis 29501 with adverse clinical outcomes.[1],[2],[26] Two studies have found that, on average, a person with tuberculosis in a low- and middle-income country will experience catastrophic costs as a result of the illness.[2],[27]
tuberculosis 29641 country will experience catastrophic costs as a result of the illness.[2],[27] In this review, one tuberculosis -specific intervention provided cash equivalent to 173% of estimated annual individual income,[17] four
tuberculosis 29986 reported the intervention as percentage of annual household income, between 3–6%.[15],[21] The single tuberculosis -sensitive intervention we identified provided cash equivalent to 3.8% of estimated annual individual
tuberculosis 30131 identified provided cash equivalent to 3.8% of estimated annual individual income. The difference between tuberculosis -specific and tuberculosis-sensitive interventions may reflect the findings that sensitive interventions
tuberculosis 30157 equivalent to 3.8% of estimated annual individual income. The difference between tuberculosis-specific and tuberculosis -sensitive interventions may reflect the findings that sensitive interventions are less likely to be
tuberculosis 30323 sensitive interventions are less likely to be effective and affordable by countries for offsetting tuberculosis -associated catastrophic costs than specific interventions.[27] However, tuberculosis-sensitive interventions
tuberculosis 30408 for offsetting tuberculosis-associated catastrophic costs than specific interventions.[27] However, tuberculosis -sensitive interventions also have the advantage of a broader poverty reduction impact, which might improve
tuberculosis 30600 impact, which might improve household economic resilience before a household member develops active tuberculosis infection.Beyond simply offsetting costs, cash transfer interventions may also serve as an additional
tuberculosis 31511 transfer intervention. The incentive of a conditional intervention may be particularly important in tuberculosis care, where consistent adherence to a multiple-drug regimen for a prolonged treatment course is essential
tuberculosis 31758 outcomes. However, a meta-analysis of the effect of incentives and/or enablers on medication adherence in tuberculosis was largely inconclusive, but primarily identified studies in high-income countries, where financial
tuberculosis 31970 financial interventions may have less effect.[32] Tuberculosis-sensitive interventions are likely to lack a tuberculosis -specific incentive, although they may include other conditional elements unrelated to tuberculosis,
tuberculosis 32069 tuberculosis-specific incentive, although they may include other conditional elements unrelated to tuberculosis , as in the case of the Bolsa Familia programme.[22]The studies showed substantial heterogeneity in study
tuberculosis 32274 heterogeneity in study design. However, there was no measured heterogeneity within the subset of studies with tuberculosis -specific interventions that were not at high overall risk of bias. Although factors related to the population,
tuberculosis 32996 socioeconomic interventions, predominantly food provision, may improve clinical outcomes in active tuberculosis .[36] To better understand which forms of social protection are most effective at improving clinical
tuberculosis 33122 better understand which forms of social protection are most effective at improving clinical outcomes for tuberculosis , non-cash strategies should be studied comparatively and in combination with cash transfer interventions.While
tuberculosis 33407 interventions on household and national or subnational outcomes, like contact screening and overall tuberculosis incidence, must also be considered. For example, a multivariable analysis found that municipalities
tuberculosis 33613 municipalities in Brazil with higher coverage by the Bolsa Familia programme had a significant reduction in tuberculosis incidence compared to those with lower coverage.[37]In conclusion, we found some evidence that cash
tuberculosis 33810 evidence that cash transfer interventions improve treatment outcomes in patients with active pulmonary tuberculosis in low- and middle-income countries, although the overall quality of this evidence is low. These findings
tuberculosis 34042 by WHO and others to incorporate cash transfer interventions into social protection schemes within tuberculosis treatment programmes.[1],[6] In addition, high-quality research is needed to better understand the effectiveness
tuberculosis 34171 programmes.[1],[6] In addition, high-quality research is needed to better understand the effectiveness of tuberculosis -specific and tuberculosis-sensitive cash transfer interventions, including understanding of the optimal
tuberculosis 34197 high-quality research is needed to better understand the effectiveness of tuberculosis-specific and tuberculosis -sensitive cash transfer interventions, including understanding of the optimal amount, conditional feature,

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