Strengthening community-centred outreach workflows for post-tuberculosis lung disease (PTLD) screening and follow-up in Lima, Peru

I will be working with Socios en Salud (SES), the Peru-based sister organisation of Partners in Health, which works closely with local communities and the Ministry of Health to strengthen access to care, especially in urban and peri-urban settings in Lima. 

Focus areas (aligned with Sustainable Development Goals):

• SDG 3: Good health and well-being 

• SDG 10: Reduced inequalities

• SDG 11: Sustainable cities and communities

Background

Approximately 10 million new cases of tuberculosis (TB) are recorded each year, with the vast majority occurring in low- and middle-income countries. 

Beyond the immediate illness and risk of death, TB often causes permanent respiratory impairment after treatment has been completed. While preventive care and early diagnosis can reduce this risk, many TB survivors go on to experience post-tuberculosis lung disease (PTLD), an umbrella term for these chronic respiratory conditions caused by the lasting lung damage following TB infection, even after bacteriological cure. 

Despite its substantial burden, major knowledge gaps remain around PTLD, including its frequency, which patients are at highest risk, how best to screen for it and what interventions may reduce its long-term impact on lung function and overall health. This hinders the identification of individuals at highest risk and the development of evidence-based clinical guidance for PTLD intervention. 

Objective

I will be contributing to the Beat PTLD project, which builds on an existing cohort of 1000 successfully treated TB patients to study the occurrence and forms of post-TB lung impairment. This broader study aims to: 

1. Characterise PTLD phenotypes using spirometry, high-resolution chest CT and echocardiography; 
2. Identify risk factors and develop a predictive model to help triage TB patients at higher risk of PTLD; 
3. Assess the contributions of host and bacterial genetic variation to PTLD; 
4. Evaluate functional assays, questionnaires and biomarkers as possible screening tools for PTLD 

Within this project, my main role will be to support ethical, community-centred fieldwork alongside community health workers at SES, while helping strengthen small-scale outreach processes to improve consistency, documentation and follow-through. 

Given that my role will become more clearly defined and I will have a clearer understanding of day-to-day field logistics once I am on site, my responsibilities may develop over time in response to the team’s needs, so in addition to outreach support, I may also contribute to data collection, systemisation, analysis or evaluation of project outcomes. 

Goals

SMART goal 1: Field support and documentation

By the end of week 6, I am to maintain a structured field log for each outreach day, documenting activities, operational challenges and follow-up actions, and to share a short weekly synthesis with the team. 

SMART goal 2: Create a practical tool for the team to use

By week 4, I am to co-design and pilot one practical outreach support tool with the team, such as a checklist, call/visit workflow or tally sheet, and refine it by week 6 based on feedback for handover. 

SMART goal 3: Capture learning and recommendations 

By the end of week 6, I am to produce a brief summarising barriers and facilitators in patient screening and follow-up, together with low-cost, actionable recommendations discussed with the team in a final debrief. 

Outputs to deliver

• Consistent field support to community health workers during outreach activities
• A structured field log summarising areas visited, outreach approach used, barriers encountered, follow-ups needed, and referrals made
• A brief capturing lessons learned on patient outreach, screening and follow-up
• A draft or revised outreach checklist aligned with the team's standard operating procedures to support more consistent tracking of outreach progress 

Expected outcomes

• More consistent documentation of the community-based PTLD screening workflow 
• Fewer missed follow-ups or smoother coordination with patients, through clearer task allocation and shared checklists 
• Better visibility into where bottlenecks occur, such as contact availability, address accuracy or stigma