Comparing Additionality of Tuberculosis Cases Using GeneXpert or Smear-Based Active TB Case-Finding Strategies among Social Contacts of Index Cases in Nepal.
ACF interventions
GeneXpert
Nepal
TB yield rate
active case-finding
Journal
Tropical medicine and infectious disease
ISSN: 2414-6366
Titre abrégé: Trop Med Infect Dis
Pays: Switzerland
ID NLM: 101709042
Informations de publication
Date de publication:
17 Jul 2023
17 Jul 2023
Historique:
received:
08
06
2023
revised:
11
07
2023
accepted:
13
07
2023
medline:
28
7
2023
pubmed:
28
7
2023
entrez:
28
7
2023
Statut:
epublish
Résumé
This study compares the yield and additionality of community-based active tuberculosis (TB) active case-finding strategies using either smear microscopy or GeneXpert as the TB diagnostic test. Active case-finding strategies screened social contacts of index cases and high-risk groups in four districts of Nepal in July 2017-2019. Two districts (Chitwan and Dhanusha) applied GeneXpert testing and two districts (Makwanpur and Mahotarri) used smear microscopy. Two control districts implemented standard national TB program activities. Districts implementing GeneXpert testing screened 23,657 people for TB, tested 17,114 and diagnosed 764 TB cases, producing a yield of 4.5%. Districts implementing smear microscopy screened 19,961 people for TB, tested 13,285 and diagnosed 437 cases, producing a yield of 3.3%. The screening numbers required were 31 for GeneXpert and 45.7 for smear districts. The test numbers required were 22.4 and 30.4 for GeneXpert and smear. Using the TB REACH additionality method, social contact tracing for TB through GeneXpert testing contributed to a 20% (3958/3322) increase in district-level TB notifications, smear microscopy 12.4% (3146/2798), and -0.5% (2553/2566) for control districts. Therefore, social contact tracing of TB index cases using GeneXpert testing should be implemented throughout Nepal within the TB FREE initiative to close the notification gap and accelerate progress toward END TB strategy targets.
Identifiants
pubmed: 37505665
pii: tropicalmed8070369
doi: 10.3390/tropicalmed8070369
pmc: PMC10384436
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : European Union, Horizon 2020
ID : 733174
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