Predicted Impact of Vaccination and Active Case Finding Measures to Control Epidemic of Coronavirus Disease 2019 in a Migrant-Populated Area in Thailand

Diabetes Mellitus (DM) is a non-communicable disease that contributes to the cause of death. Based on the analysis of the situation in Kawengen Village, Semarang Regency, there were several problems related to the incidence of DM, including the Non-Communicable Disease Integrated Guidance Post Program (Posbindu PTM), which was not running optimally. Based on these problems, it is necessary to form a movement called the Anti-Diabetes Mellitus Community Alert Movement (SIMANIS). Active case finding and detection of pre-DM cases aim to capture people who already have pre-DM symptoms, but they do not know. Furthermore, if caught, they can be followed up so that they are willing to go to the health service unit before complications occur. The implementation of this community service activity is carried out in four stages, namely the formation of SIMANIS cadres, education on prevention and control of DM to SIMANIS cadres and the community, ToT on how to fill in and use the SIDIA Card (pre-diabetes screening) to SIMANIS cadres, and use of the SIDIA Card for early detection active case finding pre-DM. There was an increase in the pre-post education knowledge score from 7.59 + 1.5 to 8.93 + 0.9 and an increase in the pre-post education attitude score from 7.96 + 1.22 to 9.07 + 0.78. SIMANIS through the use of the SIDIA Card can be used to increase public awareness in prevention, early detection, and case finding of DM.

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COVID-19 control strategies and intervention effects in resource limited settings: A modeling study

PLoS ONE ◽

10.1371/journal.pone.0252570 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252570

Author(s):

Kiran Raj Pandey ◽

Anup Subedee ◽

Bishesh Khanal ◽

Bhagawan Koirala

Keyword(s):

Control Strategies ◽

Case Finding ◽

Contact Tracing ◽

Active Case Finding ◽

Resource Limited Settings ◽

Peak Demand ◽

Active Case ◽

Resource Limited ◽

Base Scenario ◽

Annual Mortality

Introduction Many countries with weaker health systems are struggling to put together a coherent strategy against the COVID-19 epidemic. We explored COVID-19 control strategies that could offer the greatest benefit in resource limited settings. Methods Using an age-structured SEIR model, we explored the effects of COVID-19 control interventions–a lockdown, physical distancing measures, and active case finding (testing and isolation, contact tracing and quarantine)–implemented individually and in combination to control a hypothetical COVID-19 epidemic in Kathmandu (population 2.6 million), Nepal. Results A month-long lockdown will delay peak demand for hospital beds by 36 days, as compared to a base scenario of no intervention (peak demand at 108 days (IQR 97-119); a 2 month long lockdown will delay it by 74 days, without any difference in annual mortality, or healthcare demand volume. Year-long physical distancing measures will reduce peak demand to 36% (IQR 23%-46%) and annual morality to 67% (IQR 48%-77%) of base scenario. Following a month long lockdown with ongoing physical distancing measures and an active case finding intervention that detects 5% of the daily infection burden could reduce projected morality and peak demand by more than 99%. Conclusion Limited resource settings are best served by a combination of early and aggressive case finding with ongoing physical distancing measures to control the COVID-19 epidemic. A lockdown may be helpful until combination interventions can be put in place but is unlikely to reduce annual mortality or healthcare demand.

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Performance of Xpert MTB/RIF Ultra for tuberculosis diagnosis in the context of passive and active case finding

European Respiratory Journal ◽

10.1183/13993003.00257-2021 ◽

2021 ◽

pp. 2100257

Author(s):

Belén Saavedra ◽

Edson Mambuque ◽

Dinis Nguenha ◽

Neide Gomes ◽

Shilzia Munguane ◽

...

Keyword(s):

Health Care Services ◽

Field Evaluation ◽

Case Finding ◽

Smear Microscopy ◽

Active Case Finding ◽

Active Case ◽

Care Services ◽

Previously Treated ◽

Tuberculosis Diagnosis ◽

Composite Reference Standard

We present a field evaluation of the diagnostic accuracy of Xpert MTB/RIF (Xpert) and Xpert MTB/RIF Ultra (Ultra), using two cohorts in a high TB/HIV burden setting in Southern Mozambique. Single respiratory specimens from symptomatic adults accessing health care services (passive case finding (PCF) cohort), and from household and community close contacts (active case finding (ACF) cohort), were tested by smear microscopy, culture, Xpert and Ultra. Liquid and solid culture served as a composite reference standard. We explored trace results’ impact on specificity via their recategorisation to negative (in all and just among those previously treated individuals) A total of 1419 and 252 participants were enrolled in the PCF and ACF cohorts, respectively. For the PCF cohort, Ultra showed higher sensitivity than Xpert overall (0.95 (95% CI: 0.90, 0.98) versus 0.88 (0.82, 0.93); p<0.001) and among smear negative patients (0.63 (0.48, 0.76) and 0.84 (0.71, 0.93). Ultra's specificity was lower than Xpert's (0.98 (0.97, 0.99) versus 0.96 (0.95, 0.97); p=0.008). For ACF, sensitivities were the same (0.67 (95% CI: 0.22,0.96) for both tests), although Ultra detected a higher number of microbiologically confirmed samples than Xpert (4.7% (12/252) versus 2.7% (7/252)). Conditional recategorisation of trace results among previously treated participants maintained differences in specificity in the PCF cohort. These results add evidence on the improved sensitivity of Ultra and support its use in different case finding scenarios.

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