TABLE.

Lessons Learned and Recommendations to Address Operational Challenges Faced in Conducting TB Prevalence Surveys, Tamil Nadu, India

Challenges FacedRecommendations
Human resource training and management
  • The quality of the entire survey depends on staff training.

  • Staff attrition in large-scale surveys should be anticipated, and ready-made training materials in audio-video format should be available to train staff anytime, anywhere.

COVID-19-related disruptions
  • Staff safety must be a priority during emergency situations to avoid delays in the survey.

Low survey participation and community engagement
  • The involvement of community leaders and local community engagement is critical for the survey.

  • Implementing an information, education, and communication program through local health authorities can sensitize the community and increase survey participation.

Frequent X-ray equipment breakdowns
  • Planning cluster activities in sessions of 3–4 hours each and scheduling a 4-hour break for the X-ray unit reduces the frequency of X-ray breakdowns.

  • Care should be taken to avoid operating the X-ray unit when the outdoor temperature is high.

Laboratory issues
  • Funding for surveys should try to include a special agency for sputum transportation with cold chain monitoring exclusively for the survey.

  • Reference laboratories must be prepared with adequate staff and consumables to manage increases in samples.

  • Strong leadership and effective collaborative networks should be engaged to mobilize consumables quickly and help manage supply chain issues.

Delays in X-ray reading
  • An adequate budget should be allocated and a trained standardized radiologist/pulmonologist should be assigned to read X-rays daily so that the eligible participants can be approached as early as possible.

  • Wherever funding is possible, incorporating artificial intelligence/teleradiology should be considered.

Data management and Internet connectivity issues
  • Having a competent and responsive data management team from survey design to completion is essential.

  • To avoid data collection delays caused by connectivity issues, the survey team should be prepared to collect data on paper.

  • The use of bar codes and bar code scanners reduces errors in data entry and matching records.