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Mobile community-based active case-finding for tuberculosis among older populations in rural Cambodia

Mobile community-based active case-finding for tuberculosis among older populations in rural Cambodia

Authors :
S. Scholtissen
Maryline Bonnet
Cathy Hewison
Jean-Philippe Dousset
O Camelique
Mathieu Bastard
Institut de Recherche pour le Développement (IRD [France-Sud])
Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI)
Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM)
Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI)
Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)
Source :
International Journal of Tuberculosis and Lung Disease, International Journal of Tuberculosis and Lung Disease, International Union Against Tuberculosis and Lung Disease, 2019, 23 (10), pp.1107-1114. ⟨10.5588/ijtld.18.0611⟩
Publication Year :
2019
Publisher :
International Union Against Tuberculosis and Lung Disease, 2019.

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.

Details

ISSN :
10273719 and 18157920
Volume :
23
Database :
OpenAIRE
Journal :
The International Journal of Tuberculosis and Lung Disease
Accession number :
edsair.doi.dedup.....3886c2f341a80d0f9c0b90295590b400
Full Text :
https://doi.org/10.5588/ijtld.18.0611