O Camelique1, S Scholtissen1, J-P Dousset1, M Bonnet2, M Bastard3, C Hewison1. 1. Médecins Sans Frontières, Paris. 2. Institut de Recherche pour le Développement (IRD UMI233) Translational Research for Human Immunodeficiency Virus and Infectious Diseases (TransVIHMI), Institut national de la santé et de la recherche médicale Unité 1175, Montpellier. 3. Epicentre, Paris, France.
Abstract
OBJECTIVE: To systematically screen older rural populations in Cambodia for tuberculosis (TB) and develop an effective active case-finding (ACF) model for this TB high-risk group. DESIGN: A retrospective study using routinely collected programmatic data on community-based ACF among people aged ≥55 years using TB symptoms and systematic chest radiography (CXR) screening, followed by Xpert® MTB/RIF testing for participants with positive screening results and TB culture for certain Xpert-negative specimens. RESULTS: Of 22 101 participants included in the analysis, 7469 (33.8%) were screening-positive and 5960 (27.0%) underwent Xpert testing. Pulmonary TB was identified in 482 (2.2%) individuals: 288 (1.3%) were bacteriologically confirmed (253 using Xpert, 35 using culture) and 194 (0.9%) were clinically diagnosed. Eighty-seven people needed to be screened in order to diagnose one Xpert-positive case. Among the Xpert-positive cases, only 31.6% (80/253) reported cough ≥2 weeks, and 39.9% (101/253) were asymptomatic but had a CXR suggestive of active TB. Treatment uptake was 97.3% (469/482), and treatment success was 88.0% (424/482). CONCLUSIONS: Community-based ACF was effective in detecting and successfully treating older TB patients, most of whom might otherwise have remained undiagnosed. Mobile CXR appears to be crucial in identifying a high number of asymptomatic, bacteriologically confirmed cases.
OBJECTIVE: To systematically screen older rural populations in Cambodia for tuberculosis (TB) and develop an effective active case-finding (ACF) model for this TB high-risk group. DESIGN: A retrospective study using routinely collected programmatic data on community-based ACF among people aged ≥55 years using TB symptoms and systematic chest radiography (CXR) screening, followed by Xpert® MTB/RIF testing for participants with positive screening results and TB culture for certain Xpert-negative specimens. RESULTS: Of 22 101 participants included in the analysis, 7469 (33.8%) were screening-positive and 5960 (27.0%) underwent Xpert testing. Pulmonary TB was identified in 482 (2.2%) individuals: 288 (1.3%) were bacteriologically confirmed (253 using Xpert, 35 using culture) and 194 (0.9%) were clinically diagnosed. Eighty-seven people needed to be screened in order to diagnose one Xpert-positive case. Among the Xpert-positive cases, only 31.6% (80/253) reported cough ≥2 weeks, and 39.9% (101/253) were asymptomatic but had a CXR suggestive of active TB. Treatment uptake was 97.3% (469/482), and treatment success was 88.0% (424/482). CONCLUSIONS: Community-based ACF was effective in detecting and successfully treating older TBpatients, most of whom might otherwise have remained undiagnosed. Mobile CXR appears to be crucial in identifying a high number of asymptomatic, bacteriologically confirmed cases.
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: Alvin Kuo Jing Teo; Kiesha Prem; Yi Wang; Tripti Pande; Marina Smelyanskaya; Lisanne Gerstel; Monyrath Chry; Sovannary Tuot; Siyan Yi Journal: Int J Environ Res Public Health Date: 2021-12-02 Impact factor: 3.390
Authors: Courtney M Yuen; Daniela Puma; Ana Karina Millones; Jerome T Galea; Christine Tzelios; Roger I Calderon; Meredith B Brooks; Judith Jimenez; Carmen Contreras; Tim C Nichols; Tom Nicholson; Leonid Lecca; Mercedes C Becerra; Salmaan Keshavjee Journal: BMJ Open Date: 2021-07-07 Impact factor: 2.692