C M Yuen1, J Agaya2, W Mchembere2, D Okelloh2, M Achola3, J Opole2, J Cowden4, C M Heilig5, M W Borgdorff6, K P Cain6. 1. Harvard Medical School, Boston, MA, USA. 2. Kenya Medical Research Institute, Kisumu. 3. Kenya Medical Research Institute, US Army Medical Research Directorate-Kenya, Kisumu. 4. US Army Medical Research Directorate-Kenya, Kisumu, Kenya. 5. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. 6. CDC-Kenya, Kisumu, Kenya.
Abstract
SETTING: Efficient tuberculosis (TB) active case-finding strategies are important in settings with high TB burdens and limited resources, such as those in western Kenya. OBJECTIVE: To guide efforts to optimize screening efficiency, we identified the predictors of TB among people screened in health facilities and communities. DESIGN: During February 2015-June 2016, adults aged ≥15 years reporting any TB symptom were identified in health facilities and community mobile screening units, and evaluated for TB. We assessed the predictors of TB using a modified Poisson regression with generalized estimating equations to account for clustering according to screening site. RESULTS: TB was diagnosed in 484 (20.3%) of 2394 symptomatic adults in health facilities and 39 (3.4%) of 1424 in communities. In health facilities, >10% of symptomatic adults in all demographic groups had TB, and no predictors were associated with a ≥2-fold increased risk. In communities, the independent predictors of TB were male sex (adjusted prevalence ratio [aPR] = 4.26, 95%CI 2.43-7.45), HIV infection (aPR 2.37, 95%CI 1.18-4.77), and household TB contact in the last 2 years (aPR 2.84, 95%CI 1.62-4.96). CONCLUSION: Our findings support the notion of general TB screening in health facilities and evaluation of the adult household contacts of TB patients.
SETTING: Efficient tuberculosis (TB) active case-finding strategies are important in settings with high TB burdens and limited resources, such as those in western Kenya. OBJECTIVE: To guide efforts to optimize screening efficiency, we identified the predictors of TB among people screened in health facilities and communities. DESIGN: During February 2015-June 2016, adults aged ≥15 years reporting any TB symptom were identified in health facilities and community mobile screening units, and evaluated for TB. We assessed the predictors of TB using a modified Poisson regression with generalized estimating equations to account for clustering according to screening site. RESULTS: TB was diagnosed in 484 (20.3%) of 2394 symptomatic adults in health facilities and 39 (3.4%) of 1424 in communities. In health facilities, >10% of symptomatic adults in all demographic groups had TB, and no predictors were associated with a ≥2-fold increased risk. In communities, the independent predictors of TB were male sex (adjusted prevalence ratio [aPR] = 4.26, 95%CI 2.43-7.45), HIV infection (aPR 2.37, 95%CI 1.18-4.77), and household TB contact in the last 2 years (aPR 2.84, 95%CI 1.62-4.96). CONCLUSION: Our findings support the notion of general TB screening in health facilities and evaluation of the adult household contacts of TB patients.
Authors: Walter Mchembere; Janet Agaya; Courtney M Yuen; Douglas Okelloh; Millicent Achola; Joseph Opole; Jessica Cowden; Hellen Muttai; Charles M Heilig; Martien W Borgdorff; Kevin P Cain Journal: AIDS Date: 2019-12-01 Impact factor: 4.632
Authors: N Zokufa; K Lebelo; D Hacking; L Tabo; P Runeyi; N Malabi; S B Sibanda; T Cassidy; G Makanda; B Norman; S Khuzani; J Furin; C Jonker; B Nkasana; V Scott; C Pfaff Journal: Int J Tuberc Lung Dis Date: 2021-05-01 Impact factor: 2.373
Authors: Meredith B Brooks; Helen E Jenkins; Daniela Puma; Christine Tzelios; Ana Karina Millones; Judith Jimenez; Jerome T Galea; Leonid Lecca; Mercedes C Becerra; Salmaan Keshavjee; Courtney M Yuen Journal: Sci Rep Date: 2022-01-17 Impact factor: 4.379