Data for action: collection and use of local data to end tuberculosis

Theron, Grant; Jenkins, Helen E.; Cobelens, Frank; Abubakar, Ibrahim; Khan, Aamir; Cohen, Ted; Dowdy, David W.

doi:10.1016/s0140-6736(15)00321-9

Cited by 96 publications

(90 citation statements)

References 63 publications

(58 reference statements)

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“…However, existing data can enable NTPs and their partners to plan interventions and monitor impact at local or national level. 15 The simple methods proposed are intended to support efforts to expand and improve contact investigations, which, if implementation is incomplete, represent millions of missed opportunities to find, treat, and prevent TB in children. Care targets can help to quantify the staffing, drug supply, and health system capacity required to treat the children who are consequently diagnosed with TB disease and tuberculous infection.…”

Section: Discussionmentioning

confidence: 99%

Two methods for setting child-focused tuberculosis care targets

Yuen

Jenkins

Chang³

et al. 2016

public health action

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Section: Discussionmentioning

confidence: 99%

Two methods for setting child-focused tuberculosis care targets

Yuen

Jenkins

Chang³

et al. 2016

public health action

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“…This information will help to address current knowledge deficits [20][21][22][23][24]42 and support the global drive for active case-finding and early initiation of therapy in asymptomatic carriers of TB infection. 7,9 …”

Section: Looking Aheadmentioning

confidence: 99%

“…5,6,8 These challenges have prompted a call for international data to facilitate the improved diagnosis of TB, especially extrapulmonary TB in the asymptomatic population; additionally, there is a push for a realignment of priorities from passive to active case-finding, with an aim to eliminate the pool of TB in the asymptomatic population. 7,9 Extrapulmonary TB accounts for 15% of the health burden of TB and increases to 50% in the subpopulation of patients with HIV coinfection. 8 Ocular involvement most often manifests as uveitis, and it has been reported in up to one-fifth of patients with culture-proven TB, [10][11][12] along with significant associated ocular morbidity and visual loss.…”

mentioning

confidence: 99%

Global Variations and Challenges With Tubercular Uveitis in the Collaborative Ocular Tuberculosis Study

Agrawal

Gunasekeran

Raje³

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. The aim of this study was to examine regional variation management practices and outcomes for tubercular uveitis (TBU). METHODS.In this retrospective multinational cohort study, patients from 25 international eye care centers diagnosed with TBU with a minimum follow-up of 1 year were included. The geographic variation in treatment outcomes on survival analysis in patients with TBU were analyzed. Treatment failure is defined as a persistence or recurrence of inflammation within 6 months of completing antitubercular therapy, the inability to taper oral corticosteroids to less than 10 mg/d or topical corticosteroid drops to less than 2 drops daily, and/or recalcitrant inflammation necessitating corticosteroid-sparing immunosuppressive therapy. RESULTS.Records of 945 patients (1485 eyes) with TBU were analyzed. The mean age was 41.3 6 15.0 years (range, 4-90 years), with more males (52.9%, n ¼ 500/945) and predominant Asian ethnicity (74.4%, n ¼ 690/927). Most patients had no symptoms (92.0%, n ¼ 655/712) or history (76.7%, n ¼ 604/787) suggestive of pulmonary tuberculosis (TB). Some patients had evidence of inactive pulmonary TB on chest X-rays (26.9%, n ¼ 189/702) or chest computed tomography (68.6%, n ¼ 109/159). Patients with western geographic origin (logrank ¼ 6.47, P ¼ 0.010), African or Hispanic ethnicity (log-rank ¼ 19.9, P < 0.001), and positive immigrant status (log-rank ¼ 4.89, P ¼ 0.027) had poorer survival outcomes.CONCLUSIONS. This is a first-ever multinational analysis of TBU that highlights regional differences in treatment outcomes for this elusive form of extrapulmonary TB. Our findings will help in the design of future collaborative studies together with internists to develop best practice guidelines for this early opportunity to address TB infection and strategies to target at-risk groups such as immigrants.

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“…2 Despite widespread application of these methods, approximately one out of three new TB cases remains undiagnosed and untreated. 3,4 Consequently, these cases are concealed from national TB surveillance programs. Individuals with TB who remain undiagnosed for extended periods of time can develop adverse clinical outcomes, 5 carry increased individual monetary cost, 6 and contribute to persistent community transmission.…”

Section: Introductionmentioning

confidence: 99%

Delays and Pathways to Final Tuberculosis Diagnosis in Patients from a Referral Hospital in Urban China

Martínez

Chen

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. China is among the countries with the largest epidemic of drug susceptible and resistant tuberculosis globally. We investigated the locations tuberculosis patients visited before being diagnosed, total diagnostic delay, and risk factors associated with total delay from a large tuberculosis referral hospital in Nanjing, China. We conducted a retrospective cohort study among tuberculosis patients who initiated anti-tuberculosis treatment within 3 months prior to the study date. Patient information regarding time and locations visited while seeking care for tuberculosis-related symptoms was collected through face-to-face interviews. Crude and adjusted Cox proportional hazard ratios of factors associated with time to diagnosis were calculated. Of 179 bacteriologically confirmed patients, 37% were women and median age was 41 (interquartile range [IQR], 26-62). Public hospitals were the most commonly visited health-care institution and repeated visits to them were common. The mean days to tuberculosis diagnosis were 50.3. Female patients (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.04-1.48) or patients who contacted a health-care provider 2 weeks after becoming symptomatic (HR, 1.59; 95% CI, 1.43-1.70) were significantly less likely to have a timely diagnosis. In a referral hospital in urban China, we found that female tuberculosis patients took significantly more time to reach diagnosis than males and patients often cycled in public hospitals for multiple visits before reaching final diagnosis. Health professionals at public hospitals in Nanjing should be encouraged to refer potential tuberculosis patients as soon as possible to avoid nosocomial transmission.

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Data for action: collection and use of local data to end tuberculosis

Cited by 96 publications

References 63 publications

Two methods for setting child-focused tuberculosis care targets

Two methods for setting child-focused tuberculosis care targets

Global Variations and Challenges With Tubercular Uveitis in the Collaborative Ocular Tuberculosis Study

Delays and Pathways to Final Tuberculosis Diagnosis in Patients from a Referral Hospital in Urban China

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