A second study of the use of community leaders in case-finding for pulmonary tuberculosis in Kenya

Aluoch, J A; Karuga, Wilfred Koinange; Nsanzumuhire, H; Edwards, Eric; Stott, H.; Fox, Wallace; Sutherland, Ian

doi:10.1016/0041-3879(78)90001-6

Cited by 11 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…World Bank Income Gross National Income per capita: low income (≤$1,005 per yr); lower-middle income ($1,006 to $3,975 per yr); upper-middle income ($3,976 to $12,275 per yr); high income (≥$12,276 per yr) [22]. # : [9, 33, 34, 38, 42–46, 54, 56–58, 60, 62, 63, 66–68, 70–73, 75, 76, 79, 82, 84, 85, 88, 90, 91, 95, 97, 99–101, 234]; ¶ : [30, 31, 111–113, 116, 119, 120, 122, 134, 135, 137, 138, 148–150, 154, 165, 166, 170, 177]. …”

Section: Resultsmentioning

confidence: 99%

Contact investigation for tuberculosis: a systematic review and meta-analysis

Fox

Barry

Britton

et al. 2012

European Respiratory Journal

581

542

View full text Add to dashboard Cite

Investigation of contacts of patients with tuberculosis (TB) is a priority for TB control in high-income countries, and is increasingly being considered in resource-limited settings. This review was commissioned for a World Health Organization Expert Panel to develop global contact investigation guidelines.We performed a systematic review and meta-analysis of all studies reporting the prevalence of TB and latent TB infection, and the annual incidence of TB among contacts of patients with TB.After screening 9,555 titles, we included 203 published studies. In 95 studies from low- and middle-income settings, the prevalence of active TB in all contacts was 3.1% (95% CI 2.2–4.4%, I2=99.4%), microbiologically proven TB was 1.2% (95% CI 0.9–1.8%, I2=95.9%), and latent TB infection was 51.5% (95% CI 47.1–55.8%, I2=98.9%). The prevalence of TB among household contacts was 3.1% (95% CI 2.1–4.5%, I2=98.8%) and among contacts of patients with multidrug-resistant or extensively drug-resistant TB was 3.4% (95% CI 0.8–12.6%, I2=95.7%). Incidence was greatest in the first year after exposure. In 108 studies from high-income settings, the prevalence of TB among contacts was 1.4% (95% CI 1.1–1.8%, I2=98.7%), and the prevalence of latent infection was 28.1% (95% CI 24.2–32.4%, I2=99.5%). There was substantial heterogeneity among published studies.Contacts of TB patients are a high-risk group for developing TB, particularly within the first year. Children <5 yrs of age and people living with HIV are particularly at risk. Policy recommendations must consider evidence of the cost-effectiveness of various contact tracing strategies, and also incorporate complementary strategies to enhance case finding.

show abstract

Section: Resultsmentioning

confidence: 99%

Contact investigation for tuberculosis: a systematic review and meta-analysis

Fox

Barry

Britton

et al. 2012

European Respiratory Journal

581

542

View full text Add to dashboard Cite

show abstract

“…Few case-finding surveys have been conducted in Africa and most of these were in the pre-HIV era [8], [9], [10], [11], [12], [13]. These early surveys gave invaluable information about the epidemiology of TB, without HIV, and lead to the formulation of the current TB control strategy- DOTS, which relies on passive case-finding by investigating only those individuals presenting to the health services with symptoms of prolonged cough or haemoptysis.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities: Implications for Tuberculosis Control in the Era of HIV

et al. 2009

View full text Add to dashboard Cite

BackgroundThe Stop TB Partnership target for tuberculosis is to have reduced the prevalence of tuberculosis by 50% comparing 2015 to 1990. This target is challenging as few prevalence surveys have been conducted, especially in high burden tuberculosis and HIV countries. Current tuberculosis control strategies in high HIV prevalent settings are therefore based on limited epidemiological evidence and more evidence is needed from community-based surveys to inform improved policy formulation.Methods and Findings8044 adults were sampled from 2 sub-districts (wards) in Lusaka province, Zambia. Questionnaires were used to screen for symptoms, respiratory samples were obtained for culture and oral secretions collected for HIV testing. 79 individuals were found to have Mycobacterium tuberculosis in their sputum, giving an adjusted overall prevalence of tuberculosis of 870/100,000 (95% CI 570–1160/100,000). The adjusted overall prevalence of HIV was 28.61% (95% CI 26.04–31.19). HIV- infection was significantly associated with prevalent tuberculosis (Adj OR 2.3, 95% CI 1.42–3.74) and the population attributable fraction of HIV for prevalent tuberculosis was 36%. Symptoms such as prolonged cough (adj OR 12.72, 95% CI 7.05–22.94) and fever (Adj OR 2.04, 95%CI 1.23–3.39), were associated with prevalent tuberculosis, but 8 (10%) individuals with prevalent tuberculosis denied having any symptoms at all and only 34 (43%) would have been classified as a TB suspect by current guidelines.ConclusionsUndiagnosed tuberculosis is a challenge for tuberculosis control and new approaches are needed if we are to reach international targets. Epidemiological studies can inform screening algorithms for both detection and prevention of active tuberculosis.

show abstract

“…35 Conversely, studies from Kenya on alternative approaches to improving case-finding identified many untreated smear-positive TB cases. [36][37][38][39][40] Yet there appears to be no consensus on the role of active case-finding in low-income settings. Some disparage it for increasing the workload and cost of health services, while others believe it is highly cost-effective in countries with high prevalence, low case-finding, and moderate-to-high treatment completion.…”

mentioning

confidence: 99%

TB case-finding in southern Ethiopia

Shargie

Mørkve

Lindtjørn

2006

Bull World Health Organ

View full text Add to dashboard Cite

Objective To ascertain whether case-finding through community outreach in a rural setting has an effect on case-notification rate, symptom duration, and treatment outcome of smear-positive tuberculosis (TB). Methods We randomly allocated 32 rural communities to intervention or control groups. In intervention communities, health workers from seven health centres held monthly diagnostic outreach clinics at which they obtained sputum samples for sputum microscopy from symptomatic TB suspects. In addition, trained community promoters distributed leaflets and discussed symptoms of TB during house visits and at popular gatherings. Symptomatic individuals were encouraged to visit the outreach team or a nearby health facility. In control communities, cases were detected through passive case-finding among symptomatic suspects reporting to health facilities. Smear-positive TB patients from the intervention and control communities diagnosed during the study period were prospectively enrolled. Findings In the 1-year study period, 159 and 221 cases of smear-positive TB were detected in the intervention and control groups, respectively. Case-notification rates in all age groups were 124.6/10 5 and 98.1/10 5 person-years, respectively (P = 0.12). The corresponding rates in adults older than 14 years were 207/10 5 and 158/10 5 person-years, respectively (P = 0.09). The proportion of patients with >3 months' symptom duration was 41% in the intervention group compared with 63% in the control group (P<0.001). Pre-treatment symptom duration in the intervention group fell by 55-60% compared with 3-20% in the control group. In the intervention and control groups, 81% and 75%, respectively of patients successfully completed treatment (P = 0.12). Conclusion The intervention was effective in improving the speed but not the extent of case finding for smear-positive TB in this setting. Both groups had comparable treatment outcomes.Keywords Tuberculosis -prevention and control; Disease notification; Tuberculosis -diagnosis; Ethiopia (source: MeSH, NLM). Mots clés Tuberculose -prévention et contrôle; Notification maladie; Tuberculose -diagnostic; Ethiopie (source: MeSH, INSERM). Palabras clave Tuberculosis -prevención y control; Notificación de enfermedad; Tuberculosis -diagnóstico; Etiopía (fuente: DeCS, BIREME). Voir page 117 le résumé en français. En la página 117 figura un resumen en español.

show abstract

A second study of the use of community leaders in case-finding for pulmonary tuberculosis in Kenya

Cited by 11 publications

References 8 publications

Contact investigation for tuberculosis: a systematic review and meta-analysis

Contact investigation for tuberculosis: a systematic review and meta-analysis

Prevalence of Tuberculosis, HIV and Respiratory Symptoms in Two Zambian Communities: Implications for Tuberculosis Control in the Era of HIV

TB case-finding in southern Ethiopia

Contact Info

Product

Resources

About