Are neighbourhoods of tuberculosis cases a high-risk population for active intervention? A protocol for tuberculosis active case finding

Background Indonesia has the second largest tuberculosis (TB) burden globally. Attempts to scale-up TB control efforts have focused on TB households. However, in most high burden settings, considerable Mycobacterium tuberculosis (Mtb) transmission occurs outside TB households. A better understanding of transmission dynamics in an urban setting in Indonesia will be crucial for the TB Control Program in scaling up efforts towards elimination of TB in a more targeted way. Therefore, the study aims to measure TB prevalence and incidence in household contacts and neighbourhoods in the vicinity of known TB cases and to assess their genomic and epidemiological relatedness. Methods and analysis Individuals (~1000) living in the same household as a case diagnosed with pulmonary TB (n = 250) or in a neighbouring household (~4500 individuals) will be screened for TB symptoms and by chest x-ray. Two sputum samples will be collected for microbiological analysis from anyone with a productive cough. Any person found to have TB will be treated by the National TB Control Program. All those with no evidence of TB disease will have a repeat screen at 12 months. Whole-genome sequencing (WGS) and social network analysis (SNA) will be conducted on Index cases and contacts diagnosed with TB.

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Faculty Opinions recommendation of Challenges of interferon-γ release assay conversions in serial testing of health-care workers in a TB control program.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717952787.793458317 ◽

2012 ◽

Author(s):

Richard ZuWallack ◽

Fatima Ajaz

Keyword(s):

Health Care ◽

Health Care Workers ◽

Control Program ◽

Interferon Γ ◽

Tb Control ◽

Serial Testing ◽

Care Workers ◽

Release Assay ◽

Tb Control Program

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A study on the incidence of tuberculosis in Narail district of Bangladesh

Mediscope ◽

10.3329/mediscope.v5i2.37143 ◽

2018 ◽

Vol 5 (2) ◽

pp. 12-15

Author(s):

MS Mallick

Keyword(s):

Control Program ◽

Situational Analysis ◽

Pulmonary Tb ◽

Tb Control ◽

Related Data ◽

Number Of Patients ◽

Case Rate ◽

Extra Pulmonary ◽

The Government ◽

Tb Control Program

The aim of this descriptive type of study on diagnosed tuberculosis (TB) cases was to evaluate the incidence of TB in Narail district to have a situational analysis with the achievement of National TB Control Program. Related data were collected from the Civil Surgeon Office, Narail district. The data of 3 upazilas- Narail Sadar, Kalia, and Lohagora were used. The study period was from January 1, 2016 to December 31, 2016. The overall TB case rate was 156.6 per 100000 population and separately 170.9 per 100000 population in Narail Sadar, 142.2 per 100000 population in Kalia and 156.6 per 100000 population in Lohagora. Of the cases, 56.4% were male and 43.6% female. Overall, 89.7% of the TB cases had pulmonary TB and 10.3% had extra-pulmonary TB. The population with higher age had higher proportion having TB. The highest number of patients were referred for diagnosis by sastha sebika (nurse) and non-government field staff. The TB incidence in Narail district was considered to be lower than the National situation. However, it seems that TB will remain as a continuous concern for many years in future for the country as well as Narail district. The activities of National TB Control Program of the Government of Bangladesh needs to be strengthened further to combat TB in BangladeshMediscope Vol. 5, No. 2: Jul 2018, Page 12-15

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GP management of community-acquired pneumonia in Italy: the ISOCAP study

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2005.654 ◽

2005 ◽

Vol 63 (1) ◽

Cited By ~ 3

Author(s):

C.M. Sanguinetti ◽

F. De Benedetto ◽

C.F. Donner

Keyword(s):

Outpatient Treatment ◽

The Elderly ◽

Community Acquired Pneumonia ◽

Microbiological Analysis ◽

X Ray ◽

Systemic Arterial Hypertension ◽

Chest X Ray ◽

Socioeconomic Burden ◽

Copd Diagnosis ◽

Observation Period

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

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Factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in Cali, Colombia

Revista Panamericana de Salud Pública ◽

10.26633/rpsp.2019.14 ◽

2019 ◽

Vol 43 ◽

pp. 1

Author(s):

Cindy Córdoba ◽

Lucy Luna ◽

Diana M. Triana ◽

Freddy Perez ◽

Lucelly López

Keyword(s):

Pulmonary Tuberculosis ◽

Treatment Initiation ◽

Control Program ◽

Diagnosis And Treatment ◽

Individual Treatment ◽

Tb Control ◽

Factors Associated ◽

Tb Treatment ◽

Tuberculosis Diagnosis ◽

Tb Control Program

Objective.To determine factors associated with delays in pulmonary tuberculosis diagnosis and treatment initiation in the city of Cali, Colombia.Methods.This was a retrospective cohort study of cases of tuberculosis (TB) reported in the TB control program of Cali between January and December 2016. The information was collected from the databases of the TB control program, individual treatment cards, and clinical histories. The variables considered were sociodemographic factors, clinical factors, substance use, and performance of the health service.Results.A total of 623 cases were identified, of which 57.0% were male. The median age was 42 years (interquartile range (IQR): 27–60). The median time from onset of symptoms to TB diagnosis was 57 days (IQR: 21–117), and from onset of symptoms to TB treatment initiation was 72 days (IQR: 35–145). A factor associated with longer time from the onset of symptoms to TB treatment was being a previously treated TB patient (coefficient: 123.8 days, 95% confidence interval (CI): 48.3 to 199.3). In contrast, being incarcerated was a protective factor for earlier TB treatment initiation (coefficient: -57.3 days; 95% CI: -92.4 to -22.3).Conclusions.Our results provide important information concerning risk factors that are associated with delays in the diagnosis and treatment of tuberculosis, and that are subject to future interventions. Health insurance program managers must work together with health care providers on issues that include patient care, health promotion, and updating TB protocols and standards.

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Implementasi Program Penanggulangan TB Paru dengan Strategi Directly Observed Treatment Shortcourse di Puskesmas Panyabungan Jae Kabupaten Mandailing Natal

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v10i1.284 ◽

2021 ◽

Vol 10 (1) ◽

pp. 83

Author(s):

Mawaddah Marahmah ◽

Rapotan Hasibuan

Keyword(s):

Control Program ◽

Public Knowledge ◽

Political Commitment ◽

Data Presentation ◽

Tb Control ◽

Directly Observed Treatment ◽

Descriptive Approach ◽

Using Data ◽

Depth Interviews ◽

Tb Control Program

TB cases in Southeast Asia contribute 40% of the world's TB cases and causes the highest mortality in Indonesia. Panyabungan Jae Health Center (PJHC) itself has the highest number of TB cases in Mandailing Natal Regency. This study, therefore, aimed to determine the implementation of the TB Control Program with the Directly Observed Treatment Shortcourse Strategy (DOTS) at PJHC.Qualitative methods with descriptive approach was used for this research. In-depth interviews was conducted with 5 informants in July 2020. The data were analyzed using data reduction, data presentation, and conclusion drawing.The research found that communication between the TB program officer and the DOTS strategy worked well in the PJHC as well as the disposition, resources and bureaucratic structures. Political commitment in the DOTS strategy with cross-sectoral cooperation has an important influence in the handling of TB cases,however village authorities have not played a role in efforts to reduce for number of TB cases. The patients had lack of understanding about TB and some localshad views TB as a disease caused by poison becomes an obstacle in treating patients. TB prevention with the DOTS strategy at the PJHC runs according to standard guidelines, and complemented by the Puskesmas innovation "Tor Tor Libas TB".The MNDHO officersare advised to collaborate with entire stakeholders in overcoming TB by strengthening education in the form of routine counseling to increase public knowledge about TB

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Identification of TB space-time clusters and hotspots in Ouest département, Haiti, 2011–2016

Public Health Action ◽

10.5588/pha.20.0085 ◽

2021 ◽

Vol 11 (2) ◽

pp. 101-107

Author(s):

A. M. Dismer ◽

M. Charles ◽

N. Dear ◽

J. M. Louis-Jean ◽

N. Barthelemy ◽

...

Keyword(s):

Metropolitan Area ◽

Urban Areas ◽

Control Program ◽

High Volume ◽

Space Time ◽

Case Finding ◽

Western Hemisphere ◽

Spatial Clusters ◽

Tb Control ◽

Tb Control Program

BACKGROUND: Haiti has the highest incidence rate of TB in the Western Hemisphere, with an estimated 170 cases per 100,000 in 2019. Since 2010, control efforts have focused on targeted case-finding activities in urban areas, implementation of rapid molecular diagnostics at high-volume TB centers, and improved reporting. TB analyses are rarely focused on lower geographic units; thus, the major goal was to determine if there were focal areas of TB transmission from 2011 to 2016 at operational geographic levels useful for the National TB Control Program (PNLT).METHODS: We created a geocoder to locate TB cases at the smallest geographic level. Kulldorff’s space-time permutation scan, Anselin Moran’s I, and Getis-Ord Gi* statistics were used to determine the spatial distribution and clusters of TB.RESULTS: With 91% of cases linked using the geocoder, TB clusters were identified each year. Getis-Ord Gi* analysis revealed 14 distinct spatial clusters of high incidences in the Port-au-Prince metropolitan area. One hundred retrospective space-time clusters were detected.CONCLUSION: Our study confirms the presence of TB hotspots in the Ouest département, with most clusters in the Port-au-Prince metropolitan area. Results will help the PNLT and its partners better design case-finding strategies for these areas.

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PHARMACISTS' PERCEPTION ABOUT THEIR ROLES IN TUBERCULOSIS CONTROL PROGRAM IN MEDAN, INDONESIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i4.16688 ◽

2017 ◽

Vol 10 (4) ◽

pp. 256

Author(s):

Khairunnisa B ◽

Azizah Nasution

Keyword(s):

Control Program ◽

Cross Sectional Study ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Tb Control ◽

Control Programs ◽

Validated Questionnaire ◽

Directly Observed Treatment ◽

Tb Control Program

Objectives: to assess the pharmacists' perception about their roles in tuberculosis (TB) control program in Medan, Indonesia. Methods: A cross-sectional study was conducted to assess the pharmacists' perception about their roles in TB control program in Medan, Indonesia using a validated questionnaire. The pharmacists involved in this study (n=117) were asked to choose answering yes, no or do not know for their perception on their roles in TB control program. The collected data consisted of demographics (gender, age, place of practice, and working experience) and the pharmacists’ perception on their roles in TB control program were organized and analyzed by applying descriptive and Chi-square analyses using Statistical Package for the Social Sciences (SPSS, version 19, Chicago, IL, USA) (p value <0.05 was considered significant). Results: Mean age of the participants was 38.6 (standard deviation=11.7) years. Most of them (76.1%) were female. Distribution of the participants by place of practice: pharmacy, 78.6%; hospital, 20.5%. Most of them (63.2%) have heard about directly observed treatment short-course (DOTS) program. More than 90% of them realized that they could play their roles as providers, managers of anti-TB drugs, drug informans, ensurers for adherence to the TB treatment, educators for patients and publics on TB and its treatment. Only 26.5% of them knew that they could also play their role as inventors of early suspected TB in the community.Conclusion: The study proved that the pharmacists’ roles could be utilized and enhanced to optimize TB control programs in Indonesia.Keywords: Pharmacists’ role, Tuberculosis, DOTS Program

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An observational report of universal GeneXpert testing of inpatients with diagnosed or presumptive TB in the Philippines

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa044 ◽

2020 ◽

Vol 114 (9) ◽

pp. 682-686

Author(s):

Aye Myat Thi ◽

Nathaniel Lee ◽

Victoria Parris ◽

Flora P Marin ◽

Lynsil Roy ◽

...

Keyword(s):

Scale Up ◽

Multidrug Resistant ◽

The Philippines ◽

Rifampicin Resistance ◽

X Ray ◽

Tb Treatment ◽

High Incidence ◽

Chest X Ray ◽

Smear Negative ◽

Observational Report

Abstract Background The Philippines is a high TB and multidrug-resistant TB burden country. Although the scale-up of GeneXpert testing is occurring, the benefits of universal Xpert-Mycobacterium tuberculosis/ rifampicin (MTB/RIF) testing in inpatients have not been documented. Methods Routine GeneXpert testing irrespective of priority criteria for testing was conducted within a prospective cohort of all adults with known or presumptive TB admitted to a tertiary infectious diseases hospital in Manila. Study-specific TB diagnosis was decided upon bacteriological results, chest x-ray assessment, if already on anti-TB treatment (ATT) at admission and a cough duration of ≥2 wk. Results Of submitted sputum samples, 87.1% (277/318) had valid acid-fast bacilli (AFB) microscopy and Xpert® MTB/RIF results. Xpert® MTB/RIF was positive in 97.7% (n = 87/89) of AFB-positive patients and 25.5% (n = 48/188) of AFB-negative patients. Bacteriological confirmation in smear negative cases not on ATT prior to admission was 25.2% (34/135). Rifampicin resistance was detected in 26/135 Xpert positive cases (19.3%), including nine who might not otherwise have been detected, representing a 53% increase in yield. Conclusion Universal GeneXpert testing in this setting enhanced the yield of bacterial confirmation, revealing a high incidence of rifampicin resistance and suggesting a need for further investigations in Xpert-negative/smear-positive patients who may not have mycobacterial TB.

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