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Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study

This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of soci...

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Autores principales: Gurung, Suman Chandra, Dixit, Kritika, Rai, Bhola, Dhital, Raghu, Paudel, Puskar Raj, Acharya, Shraddha, Budhathoki, Gangaram, Malla, Deepak, Levy, Jens W., Lönnroth, Knut, Ramsay, Andrew, Basnyat, Buddha, Thapa, Anil, Mishra, Gokul, Subedi, Bishal, Shah, Mohammad Kashim, Shrestha, Anil, Caws, Maxine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167510/
https://www.ncbi.nlm.nih.gov/pubmed/33919938
http://dx.doi.org/10.3390/tropicalmed6020050
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author Gurung, Suman Chandra
Dixit, Kritika
Rai, Bhola
Dhital, Raghu
Paudel, Puskar Raj
Acharya, Shraddha
Budhathoki, Gangaram
Malla, Deepak
Levy, Jens W.
Lönnroth, Knut
Ramsay, Andrew
Basnyat, Buddha
Thapa, Anil
Mishra, Gokul
Subedi, Bishal
Shah, Mohammad Kashim
Shrestha, Anil
Caws, Maxine
author_facet Gurung, Suman Chandra
Dixit, Kritika
Rai, Bhola
Dhital, Raghu
Paudel, Puskar Raj
Acharya, Shraddha
Budhathoki, Gangaram
Malla, Deepak
Levy, Jens W.
Lönnroth, Knut
Ramsay, Andrew
Basnyat, Buddha
Thapa, Anil
Mishra, Gokul
Subedi, Bishal
Shah, Mohammad Kashim
Shrestha, Anil
Caws, Maxine
author_sort Gurung, Suman Chandra
collection PubMed
description This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092; 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4; 95%CI = 1.12–1.72; p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally.
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spelling pubmed-81675102021-06-02 Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study Gurung, Suman Chandra Dixit, Kritika Rai, Bhola Dhital, Raghu Paudel, Puskar Raj Acharya, Shraddha Budhathoki, Gangaram Malla, Deepak Levy, Jens W. Lönnroth, Knut Ramsay, Andrew Basnyat, Buddha Thapa, Anil Mishra, Gokul Subedi, Bishal Shah, Mohammad Kashim Shrestha, Anil Caws, Maxine Trop Med Infect Dis Article This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092; 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4; 95%CI = 1.12–1.72; p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally. MDPI 2021-04-14 /pmc/articles/PMC8167510/ /pubmed/33919938 http://dx.doi.org/10.3390/tropicalmed6020050 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gurung, Suman Chandra
Dixit, Kritika
Rai, Bhola
Dhital, Raghu
Paudel, Puskar Raj
Acharya, Shraddha
Budhathoki, Gangaram
Malla, Deepak
Levy, Jens W.
Lönnroth, Knut
Ramsay, Andrew
Basnyat, Buddha
Thapa, Anil
Mishra, Gokul
Subedi, Bishal
Shah, Mohammad Kashim
Shrestha, Anil
Caws, Maxine
Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
title Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
title_full Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
title_fullStr Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
title_full_unstemmed Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
title_short Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
title_sort comparative yield of tuberculosis during active case finding using genexpert or smear microscopy for diagnostic testing in nepal: a cross-sectional study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167510/
https://www.ncbi.nlm.nih.gov/pubmed/33919938
http://dx.doi.org/10.3390/tropicalmed6020050
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