SETTING:A high tuberculosis (TB) burden rural area in South Africa. OBJECTIVE: To compare TB case yield and disease profile among bacille Calmette-Guérin (BCG) vaccinated children using two case-finding strategies from birth until 2 years of age. DESIGN:BCG-vaccinated infants were enrolled within 2 weeks of birth and randomised to 3-monthly home visits for questionnaire-based TB screening plus record surveillance of TB registers, hospital admission and X-ray lists at health facilities for TB suspects and cases (Group 1), or record surveillance (as above) only (Group 2). Both groups received a close-out visit after 2 years. Participants were evaluated for suspected TB disease using standardised investigations. RESULTS:A total of 4786 infants were enrolled: 2392 were randomised to Group 1 and 2394 to Group 2. The case-finding rate was significantly greater in Group 1 (2.2/100 py) than in Group 2 (0.8/100 py), with a case-finding rate ratio of 2.6 (95%CI 1.8-4.0, P < 0.001). Although the proportion of cases with bacteriological confirmation was lower in Group 1, this difference did not reach statistical significance. There was also no significant difference in the proportions with TB symptoms and signs. CONCLUSION: Home visits combined with record surveillance detected significantly more cases than record surveillance with a single study-end visit. The TB case profile did not differ significantly between the two groups.
RCT Entities:
SETTING: A high tuberculosis (TB) burden rural area in South Africa. OBJECTIVE: To compare TB case yield and disease profile among bacille Calmette-Guérin (BCG) vaccinated children using two case-finding strategies from birth until 2 years of age. DESIGN: BCG-vaccinated infants were enrolled within 2 weeks of birth and randomised to 3-monthly home visits for questionnaire-based TB screening plus record surveillance of TB registers, hospital admission and X-ray lists at health facilities for TB suspects and cases (Group 1), or record surveillance (as above) only (Group 2). Both groups received a close-out visit after 2 years. Participants were evaluated for suspected TB disease using standardised investigations. RESULTS: A total of 4786 infants were enrolled: 2392 were randomised to Group 1 and 2394 to Group 2. The case-finding rate was significantly greater in Group 1 (2.2/100 py) than in Group 2 (0.8/100 py), with a case-finding rate ratio of 2.6 (95%CI 1.8-4.0, P < 0.001). Although the proportion of cases with bacteriological confirmation was lower in Group 1, this difference did not reach statistical significance. There was also no significant difference in the proportions with TB symptoms and signs. CONCLUSION: Home visits combined with record surveillance detected significantly more cases than record surveillance with a single study-end visit. The TB case profile did not differ significantly between the two groups.
Authors: Michele Tameris; Helen McShane; J Bruce McClain; Bernard Landry; Stephen Lockhart; Angelique K K Luabeya; Hennie Geldenhuys; Jacqui Shea; Gregory Hussey; Linda van der Merwe; Marwou de Kock; Thomas Scriba; Robert Walker; Willem Hanekom; Mark Hatherill; Hassan Mahomed Journal: Tuberculosis (Edinb) Date: 2013-02-12 Impact factor: 3.131
Authors: Synne Jenum; Sumithra Selvam; Nelson Jesuraj; Christian Ritz; Anneke C Hesseling; Vicky Cardenas; Esther Lau; T Mark Doherty; Harleen M S Grewal; Mario Vaz Journal: BMJ Open Respir Res Date: 2018-10-09
Authors: Michele D Tameris; Mark Hatherill; Bernard S Landry; Thomas J Scriba; Margaret Ann Snowden; Stephen Lockhart; Jacqueline E Shea; J Bruce McClain; Gregory D Hussey; Willem A Hanekom; Hassan Mahomed; Helen McShane Journal: Lancet Date: 2013-03-23 Impact factor: 79.321
Authors: Nathan David P Concepcion; Bernard F Laya; Savvas Andronikou; Pedro A N Daltro; Marion O Sanchez; Jacqueline Austine U Uy; Timothy Reynold U Lim Journal: Pediatr Radiol Date: 2017-08-29