Geographic accessibility to health facilities predicts uptake of community-based tuberculosis screening in an urban setting

Jenkins, Harri; Ayuk, Sally; Puma, Daniela; Brooks, Meredith B.; Millones, Ana Karina; Jiménez, Judith; Lecca, Leonid; Galea, Jerome T; Becerra, Mercedes C.; Keshavjee, Salmaan; Yuen, Courtney M.

doi:10.1016/j.ijid.2022.04.031

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…People aged 15-44 years-males and females-had higher test positivity than other age groups in their respective sex strata, indicating particular under-diagnosis in this age group. This is consistent with other studies 24,25 and may in part be due to working aged people being less able to access health services due to being at work when those services are open 26 . Again, innovative active case-finding methods, for example, placing mobile diagnostic services at workplaces or transport terminals 27 , may help increase TB testing among this age group.…”

Section: Discussionsupporting

confidence: 93%

Tuberculosis testing patterns in South Africa to identify groups that would benefit from increased investigation

Shapiro,

Scott,

Moultrie

et al. 2023

Sci Rep

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The National Health Laboratory Service (NHLS) collects all public health laboratory test results in South Africa, providing a cohort from which to identify groups, by age, sex, HIV, and viral suppression status, that would benefit from increased tuberculosis (TB) testing. Using NHLS data (2012–2016), we assessed levels and trends over time in TB diagnostic tests performed (count and per capita) and TB test positivity. Estimates were stratified by HIV status, viral suppression, age, sex, and province. We used logistic regression to estimate the odds of testing positive for TB by viral suppression status. Nineteen million TB diagnostic tests were conducted during period 2012–2016. Testing per capita was lower among PLHIV with viral suppression than those with unsuppressed HIV (0.08 vs 0.32) but lowest among people without HIV (0.03). Test positivity was highest among young adults (aged 15–35 years), males of all age groups, and people with unsuppressed HIV. Test positivity was higher for males without laboratory evidence of HIV than those with HIV viral suppression, despite similar individual odds of TB. Our results are an important national baseline characterizing who received TB testing in South Africa. People without evidence of HIV, young adults, and males would benefit from increased TB screening given their lower testing rates and higher test positivity. These high-test positivity groups can be used to guide future expansions of TB screening.

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Section: Discussionsupporting

confidence: 93%

Tuberculosis testing patterns in South Africa to identify groups that would benefit from increased investigation

Shapiro,

Scott,

Moultrie

et al. 2023

Sci Rep

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“…Working-aged adults are known to have higher rates of TB [34,35]. This may be due in part to working-aged adults having difficulties accessing health services due to their work hours [36]. Furthermore, the number of unspecified healthcare workers, which can be seen as a proxy for the quality of care received, is also negatively associated with a high mycobacterial load.…”

Section: Discussionmentioning

confidence: 99%

Integrating Molecular Diagnostics and GIS Mapping: A Multidisciplinary Approach to Understanding Tuberculosis Disease Dynamics in South Africa Using Xpert MTB/RIF

Scott,

Shapiro,

Da Silva

et al. 2023

Diagnostics

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An investigation was carried out to examine the use of national Xpert MTB/RIF data (2013–2017) and GIS technology for MTB/RIF surveillance in South Africa. The aim was to exhibit the potential of using molecular diagnostics for TB surveillance across the country. The variables analysed include Mycobacterium tuberculosis (Mtb) positivity, the mycobacterial proportion of rifampicin-resistant Mtb (RIF), and probe frequency. The summary statistics of these variables were generated and aggregated at the facility and municipal level. The spatial distribution patterns of the indicators across municipalities were determined using the Moran’s I and Getis Ord (Gi) statistics. A case-control study was conducted to investigate factors associated with a high mycobacterial load. Logistic regression was used to analyse this study’s results. There was striking spatial heterogeneity in the distribution of Mtb and RIF across South Africa. The median patient age, urban setting classification, and number of health care workers were found to be associated with the mycobacterial load. This study illustrates the potential of using data generated from molecular diagnostics in combination with GIS technology for Mtb surveillance in South Africa. Spatially targeted interventions can be implemented in areas where high-burden Mtb persists.

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“…Public attitudes towards participation in health screening depend on educational level, health status, health literacy levels, place of residence/geographic accessibility, and economic issues [ 30 , 31 , 32 , 33 , 34 ]. In this study, having higher education and living in urban areas were significantly associated with a higher level of compliance with health screening guidelines (performing screening tests annually), which is in line with previously published data.…”

Section: Discussionmentioning

confidence: 99%

“…Previously published data showed that the frequency of preventive health screening depends on educational level, health status, and health literacy levels [ 30 , 31 , 32 ]. Moreover, geographic accessibility to health facilities or medical laboratories, as well as the cost of tests (funding sources), may also affect the willingness to participate in screening [ 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

Preventive Health Screening during the COVID-19 Pandemic: A Cross-Sectional Survey among 102,928 Internet Users in Poland

Mularczyk-Tomczewska

Żarnowski

Gujski

et al. 2022

JCM

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Preventive screening is a highly cost-effective public health intervention. The COVID-19 pandemic may impact preventive healthcare services. This study aimed to assess the frequency of preventive health screening, as well as to identify the factors associated with compliance with health screening guidelines among adults in Poland during the COVID-19 pandemic. This cross-sectional survey was carried out between October and December 2021, among Internet users in Poland. Respondents were asked about the last date that they performed seven different screening tests. Completed questionnaires were obtained from 102,928 adults aged 18–99 years, and 57.2% were female. The most common screening tests performed in the past 12 months were blood pressure measurement (83%), blood count (66.2%), and blood sugar (63.3%). Moreover, more than half of respondents had a urinalysis (53.1%) and lipid panel (55.1%) in the past 12 months. Out of 58,904 females, 69.2% had a cervical cytology in the past 3 years. Older age, having higher education, living in urban areas, being occupationally active, having at least one chronic disease, and visiting a doctor in the past 12 months were significantly associated (p < 0.001) with a higher level of compliance with screening guidelines. This study revealed a significant gap in the performance of preventive health screening.

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Geographic accessibility to health facilities predicts uptake of community-based tuberculosis screening in an urban setting

Cited by 6 publications

References 32 publications

Tuberculosis testing patterns in South Africa to identify groups that would benefit from increased investigation

Tuberculosis testing patterns in South Africa to identify groups that would benefit from increased investigation

Integrating Molecular Diagnostics and GIS Mapping: A Multidisciplinary Approach to Understanding Tuberculosis Disease Dynamics in South Africa Using Xpert MTB/RIF

Preventive Health Screening during the COVID-19 Pandemic: A Cross-Sectional Survey among 102,928 Internet Users in Poland

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