Treatment outcome of tuberculosis patients detected using accelerated vs. passive case finding in Myanmar

Khaing, Phue; Kyaw, Nang Thu Thu; Satyanarayana, Srinath; Oo, Nay Lynn; Aung, Thwe; Oo, Horodets'kyi; Kyaw, Khine Wut Yee; Soe, Kyaw; Thein, Soe; Thwin, T; Aung, Si Thu

doi:10.5588/ijtld.18.0038

Cited by 14 publications

(14 citation statements)

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“…Limitations notwithstanding, the study had some key findings. The findings of the 572 cohort are similar to the Myanmar study (2014-16) [11]. There was a 17% reduction of unfavourable outcomes in our study while a 12% reduction was reported in the Myanmar study, though neither was statistically significant.…”

Section: Discussionsupporting

confidence: 85%

“…Though the ACF under project Axshya reduced diagnosis delay and prevalence of catastrophic costs due to TB diagnosis, it did not translate into improved treatment outcomes. However, similar to the Myanmar study, the finding in our study allays fears that people with TB detected through ACF could have poor outcomes due to delay in treatment initiation, poor adherence and treatment completion as they are relatively healthier and the diagnosis is not patient-initiated [11]. Additionally, the treatment initiation delays in our cohort of people with TB were not significantly different in the ACF and PCF groups (published elsewhere) [22].…”

Section: Discussionsupporting

confidence: 83%

“…The strength of our study was an exhaustive list of baseline variables that were collected from interviews and these were adjusted for. This has been cited as a limitation previously [11]. There were some limitations in our study.…”

Section: Discussionmentioning

confidence: 82%

“…A Nigerian study involving ACF only showed no difference in outcomes [9,10]. But for a recently published study from Myanmar that reported comparable treatment outcomes, there is limited published literature where the effect of ACF on treatment outcomes (as compared to PCF) has been assessed after adjusting for potential confounders [11]. There are no nationally representative studies where ACF has been assessed for the effect on treatment outcomes in programme settings.…”

Section: Introductionmentioning

confidence: 99%

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Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes

Shewade

Gupta

Satyanarayana

et al. 2019

Global Health Action

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Background: Community-based active case finding (ACF) for tuberculosis (TB) implemented among marginalised and vulnerable populations in 285 districts of India resulted in reduction of diagnosis delay and prevalence of catastrophic costs due to TB diagnosis. We were interested to know whether this translated into improved treatment outcomes. Globally, there is limited published literature from marginalised and vulnerable populations on the independent effect of community-based ACF on treatment outcomes when compared to passive case finding (PCF). Objectives: To determine the relative differences in unfavourable treatment outcomes (death, loss-to-follow-up, failure, not evaluated) of ACF and PCF-diagnosed people. Methods: Cohort study involving record reviews and interviews in 18 randomly selected districts. We enrolled all ACF-diagnosed people with new smear-positive pulmonary TB, registered under the national TB programme between March 2016 and February 2017, and an equal number of randomly selected PCF-diagnosed people in the same settings. We used log binomial models to adjust for confounders. Results: Of 572 enrolled, 275 belonged to the ACF and 297 to the PCF group. The proportion of unfavourable outcomes were 10.2% (95% CI: 7.1%, 14.3%) in the ACF and 12.5% (95% CI: 9.2%, 16.7%) in the PCF group (p = 0.468). The association between ACF and unfavourable outcomes remained non-significant after adjusting for confounders available from records [aRR: 0.83 (95% CI: 0.56, 1.21)]. Due to patient non-availability at their residence, interviews were conducted for 465 (81.3%). In the 465 cohort too, there was no association after adjusting for confounders from records and interviews [aRR: 1.05 (95% CI: 0.62, 1.77)]. Conclusion: We did not find significant differences in the treatment outcomes. Due to the wide CIs, studies with larger sample sizes are urgently required. Studies are required to understand how to translate the benefits of ACF to improved treatment outcomes.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes

Shewade

Gupta

Satyanarayana

et al. 2019

Global Health Action

View full text Add to dashboard Cite

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“…It is pertinent to note that before more evidence is generated, patients diagnosed with TB through ACF should be particularly monitored for treatment outcomes when compared from those diagnosed by PCF, as studies in the past had reported variable treatment outcomes. 24 , 25 , 26 …”

Section: Case Finding Strategies: Passive and Activementioning

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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Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes?

Haq

Hinderaker

Fatima³

et al. 2021

International Journal of Infectious Diseases

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Background: Pakistan implemented initiatives to detect tuberculosis (TB) patients through extended contact screening (ECS); it improved case detection but treatment outcomes need assessment. Objectives: To compare treatment outcomes of pulmonary TB (PTB) patients detected by ECS with those detected by routine passive case finding (PCF). Methods: A cohort study using secondary program data conducted in Lahore, Faisalabad and Rawalpindi districts and Islamabad in 2013-15. We used log binomial regression models to assess if ECS was associated with unfavorable treatment outcomes (death, loss-to-follow-up, failure, not evaluated) after adjusting for potential confounders. Results: We included 79,431 people with PTB; 4604 (5.8%) were detected by ECS with 4052 (88%) bacteriologically confirmed. In all PTB patients the proportion with unfavorable outcomes was not significantly different in ECS group (9.6%) compared to PCF (9.9%), however, among bacteriologically confirmed patients unfavorable outcomes were significantly lower in ECS (9.9%) than PCF group (11.6%, P = 0.001). ECS was associated with a lower risk of unfavorable outcomes (adjusted relative risk (aRR) 0.90; 95% CI 0.82-0.99) among 'all PTB' patients and bacteriologically confirmed PTB patients (aRR 0.91; 95% CI 0.82-1.00). Conclusion:In PTB patients detected by ECS the treatment outcomes were not inferior to those detected by PCF.

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Treatment outcome of tuberculosis patients detected using accelerated vs. passive case finding in Myanmar

Cited by 14 publications

References 0 publications

Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes

Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes

Case finding strategies under National Tuberculosis Elimination Programme (NTEP)

Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes?

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