Cargando…

Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India

Due to limited availability of diagnostics and capacity, people with tuberculosis do not always undergo systematic assessment for severe illness (requiring inpatient care). In Karnataka (south India), para-medical programme staff used a screening tool to identify people at ‘high risk of severe illne...

Descripción completa

Detalles Bibliográficos
Autores principales: Shewade, Hemant Deepak, Nagaraja, Sharath Burugina, Murthy, Hosadurga Jagadish Deepak, Vanitha, Basavarajachar, Bhargava, Madhavi, Singarajipura, Anil, Shastri, Suresh G., Reddy, Ramesh Chandra, Kumar, Ajay M. V., Bhargava, Anurag
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293347/
https://www.ncbi.nlm.nih.gov/pubmed/34203984
http://dx.doi.org/10.3390/tropicalmed6020102
_version_ 1783725015188897792
author Shewade, Hemant Deepak
Nagaraja, Sharath Burugina
Murthy, Hosadurga Jagadish Deepak
Vanitha, Basavarajachar
Bhargava, Madhavi
Singarajipura, Anil
Shastri, Suresh G.
Reddy, Ramesh Chandra
Kumar, Ajay M. V.
Bhargava, Anurag
author_facet Shewade, Hemant Deepak
Nagaraja, Sharath Burugina
Murthy, Hosadurga Jagadish Deepak
Vanitha, Basavarajachar
Bhargava, Madhavi
Singarajipura, Anil
Shastri, Suresh G.
Reddy, Ramesh Chandra
Kumar, Ajay M. V.
Bhargava, Anurag
author_sort Shewade, Hemant Deepak
collection PubMed
description Due to limited availability of diagnostics and capacity, people with tuberculosis do not always undergo systematic assessment for severe illness (requiring inpatient care). In Karnataka (south India), para-medical programme staff used a screening tool to identify people at ‘high risk of severe illness’, defined using indicators of very severe undernutrition, abnormal vital signs and poor performance status (any one): (i) body mass index (BMI) ≤ 14.0 kg/m(2) (ii) BMI ≤ 16.0 kg/m(2) with bilateral leg swelling (iii) respiratory rate > 24/min (iv) oxygen saturation < 94% (v) inability to stand without support. Of 3020 adults notified from public facilities (15 October to 30 November 2020) in 16 districts, 1531 (51%) were screened (district-wise range: 13–90%) and of them, 538 (35%) were classified as ‘high risk of severe illness’. Short median delays in screening from notification (five days), and all five indicators being collected for 88% of patients, suggests the feasibility of using this tool in programme settings. However, districts with poor screening coverage require further attention. To end tuberculosis deaths, screening should be followed by referral to higher facilities for comprehensive clinical evaluation, to assess the need for inpatient care. Future studies should assess the validity (especially sensitivity in picking severely ill patients) of this screening tool.
format Online
Article
Text
id pubmed-8293347
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-82933472021-07-22 Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India Shewade, Hemant Deepak Nagaraja, Sharath Burugina Murthy, Hosadurga Jagadish Deepak Vanitha, Basavarajachar Bhargava, Madhavi Singarajipura, Anil Shastri, Suresh G. Reddy, Ramesh Chandra Kumar, Ajay M. V. Bhargava, Anurag Trop Med Infect Dis Article Due to limited availability of diagnostics and capacity, people with tuberculosis do not always undergo systematic assessment for severe illness (requiring inpatient care). In Karnataka (south India), para-medical programme staff used a screening tool to identify people at ‘high risk of severe illness’, defined using indicators of very severe undernutrition, abnormal vital signs and poor performance status (any one): (i) body mass index (BMI) ≤ 14.0 kg/m(2) (ii) BMI ≤ 16.0 kg/m(2) with bilateral leg swelling (iii) respiratory rate > 24/min (iv) oxygen saturation < 94% (v) inability to stand without support. Of 3020 adults notified from public facilities (15 October to 30 November 2020) in 16 districts, 1531 (51%) were screened (district-wise range: 13–90%) and of them, 538 (35%) were classified as ‘high risk of severe illness’. Short median delays in screening from notification (five days), and all five indicators being collected for 88% of patients, suggests the feasibility of using this tool in programme settings. However, districts with poor screening coverage require further attention. To end tuberculosis deaths, screening should be followed by referral to higher facilities for comprehensive clinical evaluation, to assess the need for inpatient care. Future studies should assess the validity (especially sensitivity in picking severely ill patients) of this screening tool. MDPI 2021-06-15 /pmc/articles/PMC8293347/ /pubmed/34203984 http://dx.doi.org/10.3390/tropicalmed6020102 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
Shewade, Hemant Deepak
Nagaraja, Sharath Burugina
Murthy, Hosadurga Jagadish Deepak
Vanitha, Basavarajachar
Bhargava, Madhavi
Singarajipura, Anil
Shastri, Suresh G.
Reddy, Ramesh Chandra
Kumar, Ajay M. V.
Bhargava, Anurag
Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India
title Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India
title_full Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India
title_fullStr Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India
title_full_unstemmed Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India
title_short Screening People with Tuberculosis for High Risk of Severe Illness at Notification: Programmatic Experience from Karnataka, India
title_sort screening people with tuberculosis for high risk of severe illness at notification: programmatic experience from karnataka, india
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293347/
https://www.ncbi.nlm.nih.gov/pubmed/34203984
http://dx.doi.org/10.3390/tropicalmed6020102
work_keys_str_mv AT shewadehemantdeepak screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT nagarajasharathburugina screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT murthyhosadurgajagadishdeepak screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT vanithabasavarajachar screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT bhargavamadhavi screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT singarajipuraanil screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT shastrisureshg screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT reddyrameshchandra screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT kumarajaymv screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia
AT bhargavaanurag screeningpeoplewithtuberculosisforhighriskofsevereillnessatnotificationprogrammaticexperiencefromkarnatakaindia