Improved Detection of Tuberculosis and Multidrug-Resistant Tuberculosis among Tibetan Refugees, India

Dierberg, Kerry; Dorjee, Kunchok; Salvo, Fulvio; Cronin, Wendy A.; Boddy, J’Belle; Cirillo, Daniela María; Sadutshang, Tsetan Dorji; Chaisson, Richard E.

doi:10.3201/eid2203.140732

Cited by 21 publications

(22 citation statements)

References 6 publications

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“…After screening 2943 titles and abstracts and 271 full-text articles, 73 unique articles fulfilled our eligibility criteria (figure 1). 14–86 The reasons for excluding full-text articles are provided in figure 1. What all included studies have in common is the goal of finding ‘missing’ TB cases through ACF, while the approaches vary greatly; from contact investigation to screening people in homeless shelters (table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Nineteen percent (n=8/43) of the articles elaborated on the availability of diagnostic tests and services as key influencing factor for ACF policy implementation—with many articles referring to the availability of molecular diagnostic tests such as Xpert MTB/RIF 27 36 49 50. Decentralisation of healthcare services, national coverage of diagnostics and task sharing were perceived as facilitators of ACF policy implementation, but unavailable in many settings 33…”

Section: Resultsmentioning

confidence: 99%

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Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

et al. 2019

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ObjectiveTo explore antecedents, components and influencing factors on active case-finding (ACF) policy development and implementation.DesignScoping review, searching MEDLINE, Web of Science, the Cochrane Database of Systematic Reviews and the World Health Organization (WHO) Library from January 1968 to January 2018. We excluded studies focusing on latent tuberculosis (TB) infection, passive case-finding, childhood TB and studies about effectiveness, yield, accuracy and impact without descriptions of how this evidence has/could influence ACF policy or implementation. We included any type of study written in English, and conducted frequency and thematic analyses.ResultsSeventy-three articles fulfilled our eligibility criteria. Most (67%) were published after 2010. The studies were conducted in all WHO regions, but primarily in Africa (22%), Europe (23%) and the Western-Pacific region (12%). Forty-one percent of the studies were classified as quantitative, followed by reviews (22%) and qualitative studies (12%). Most articles focused on ACF for tuberculosis contacts (25%) or migrants (32%). Fourteen percent of the articles described community-based screening of high-risk populations. Fifty-nine percent of studies reported influencing factors for ACF implementation; mostly linked to the health system (eg, resources) and the community/individual (eg, social determinants of health). Only two articles highlighted factors influencing ACF policy development (eg, politics). Six articles described WHO’s ACF-related recommendations as important antecedent for ACF. Key components of successful ACF implementation include health system capacity, mechanisms for integration, education and collaboration for ACF.ConclusionWe identified some main themes regarding the antecedents, components and influencing factors for ACF policy development and implementation. While we know much about facilitators and barriers for ACF policy implementation, we know less about how to strengthen those facilitators and how to overcome those barriers. A major knowledge gap remains when it comes to understanding which contextual factors influence ACF policy development. Research is required to understand, inform and improve ACF policy development and implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

et al. 2019

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“…Resource mobilization for decreasing the diagnostic delays in such areas is quite challenging, and not an easy task. 8 There is also an evidence that some patients suffering from TB may be completely asymptomatic. So they may never present to the health care facility, or present after a significant delay after continuing the chain of transmission as super spreaders.…”

Section: Obstacles To Case Findingmentioning

confidence: 99%

“…It is a well known that children under 5 years of age, elderly, people living with human immunodeficiency virus (PLHIV), diabetics, smokers, alcoholics, care takers, family members, co workers and home visitors of the index case, monks, nuns, slum dwellers, prison inmates, refugees, migrant workers, etc are more vulnerable to get infected as compared to the general population. 8 , 10 , 11 , 12 , 13 , 14 , 15 Early case finding in these groups particularly will decrease the transmission and hence decrease the secondary cases in the community. The NSP for TB elimination has also proposed ACF in such vulnerable groups and even sub-classified them into urban, rural as well as tribal areas, as per requirements of that specific area.…”

Section: Obstacles To Case Findingmentioning

confidence: 99%

Case finding strategies under National Tuberculosis Elimination Programme (NTEP)

Saini

Garg

2020

Indian Journal of Tuberculosis

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Case finding, an important parameter in fight against Tuberculosis (TB) has always remained a challenge despite advances in diagnostic modalities, access to health care and administrative commitment. We are still far from reaching the goals so set as per End TB Strategy and National Strategic Plan 2017-2025, and case finding is of paramount importance for achieving the said targets. This article, after identifying the obstacles faced in case finding, explores the various case finding strategies in the perspective of diagnostics, feasibility, resource utilization and current recommendations. Need for prioritization of case finding in different settings with involvement and active participation of one and all has been discussed. Role of health education in an individual, general public and health care worker in the context of case finding has been highlighted. Research areas to strengthen case finding have been enumerated. The review concludes by bringing out the need for heightened efforts for case finding in TB as the resources are significantly diverted as the world is facing the corona virus disease 2019 (COVID-19) pandemic.

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“…5–9 Furthermore, though Xpert MTB/RIF testing (Cepheid, Sunnyvale, CA) has been shown to increase case detection rates in other populations, WHO does not provide specific recommendations regarding the use of Xpert MTB/RIF for ACF at the household level. 8–12 …”

Section: Introductionmentioning

confidence: 99%

Diagnostic yield of active case finding for tuberculosis and HIV at the household level in slums in Haiti

et al. 2017

int j tuberc lung dis

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SUMMARY Setting Haiti has the highest burden of tuberculosis (TB) in the Americas, with an estimated prevalence of 254/100,000 population. GHESKIO conducted active case finding (ACF) for TB at the household level in nine slums in Port-au-Prince. Objective We report on the prevalence of undiagnosed TB detected through GHESKIO’s ACF campaign. Design From August 1, 2014 to July 31, 2015, we conducted a retrospective cohort analysis using GHESKIO’s ACF campaign data. All individuals who reported chronic cough (cough ≥2 weeks) were tested for TB at GHESKIO, and those who were ≥10 years of age were included in the analyses. Results Of 104,097 individuals screened in the community, 5598 (5%) reported chronic cough and satisfied the study inclusion criteria. A total of 1110 (20%) were diagnosed with active TB disease (prevalence of 1066/100,000). Of the 5472 (98%) patients tested for HIV, 528 (10%) were HIV-positive; 143 (3%) patients were diagnosed with both diseases. Conclusion Household-level screening for cough, with TB and HIV testing for symptomatic patients, was a high-yield strategy, detecting a prevalence of undiagnosed disease exceeding national estimates by more than four-fold for TB, and by five-fold for HIV.

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Improved Detection of Tuberculosis and Multidrug-Resistant Tuberculosis among Tibetan Refugees, India

Abstract: The prevalence of TB is extremely high in this population and requires urgent attention.

Cited by 21 publications

References 6 publications

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review

Case finding strategies under National Tuberculosis Elimination Programme (NTEP)

Diagnostic yield of active case finding for tuberculosis and HIV at the household level in slums in Haiti

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