Enhanced tuberculosis case detection among substitution treatment patients: a randomized controlled trial

Loit, Helle‐Mai; Sepp, Tiiu; Kliiman, Kai; McNutt, Louise‐Anne; Uusküla, Anneli

doi:10.1186/1756-0500-4-192

Cited by 7 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reason for higher LTBI prevalence in the Canadian studies might be related to the use of lower TST cut-off of 5 mm, regardless of the HIV status. Utilizing interferon gamma release assay (IGRA), a survey in Estonia reported a very low LTBI prevalence (7.4%) among MMT attendees (Ruutel et al, 2011), while a similar report from the United States showed higher prevalence (34%) of IGRA positivity among crack cocaine smokers in Texas (Grimes, Hwang, Williams, Austin, & Graviss, 2007). …”

Section: Discussionmentioning

confidence: 99%

“…These programs provide a large population of PWID or PWUD with access to HIV care, utilizing the expertise of drug treatment staff in serving this population (Rothman et al, 2007). Despite the potential synergistic impact of addressing multiple co-morbidities, many countries challenged with the syndemic of HIV, TB and substance use frequently develop uncoordinated vertical programs, which are managed separately at the local and national levels (Ruutel et al, 2011; Sylla et al, 2007). Additionally, the provision of effective management and interventions of multiple co-morbidities for PWUD have been complicated by multi-level barriers to accessing health services and reciprocal mistrust between PWUD and conventional health care providers (Altice, Kamarulzaman, Soriano, Schechter & Friedland, 2010; Rothman et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Al-Darraji

Wong

Yeow

et al. 2014

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N = 196) were mostly men (95%), under 40 (median age = 36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR = 1.1 for every entry, p < 0.05) and not being HIV-infected (AOR = 6.04, p = 0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Al-Darraji

Wong

Yeow

et al. 2014

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

show abstract

“…14 Case-finding studies for TB in methadone clinics have not previously been performed in Africa; however, they have been performed elsewhere. 16–20 Selwyn et al examined rates of TB activation among HIV-infected drug users on methadone in New York City, NY, USA, and found that 4% of individuals who were purified protein derivative positive later developed active TB. 17 Another study that screened 112 methadone patients in Estonia found no active cases of TB.…”

Section: Discussionmentioning

confidence: 99%

Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania

Gupta

Mbwambo

Mteza

et al. 2014

int j tuberc lung dis

View full text Add to dashboard Cite

SUMMARY SETTING Active case finding is a World Health Organization (WHO) endorsed strategy for improving tuberculosis (TB) case detection. Despite WHO recommendations for active case finding among people who inject drugs (PWID), few studies have been published. The historical focus of case finding has been in populations that are human immunodeficiency virus-positive, incarcerated or at higher occupational risk. OBJECTIVE We sought to examine the yield of active case finding among PWID newly started on methadone in Tanzania. DESIGN Of 222 methadone clients, 156 (70%) met with study administrators; 150 consented to participate, 139 (93%) of whom were male. The median age was 34 years. A symptom-based questionnaire was developed by the investigators and administered to every consenting patient by a native Swahili speaker. RESULTS Of the 150 patients surveyed, 16 (11%) had one or more TB symptoms and were referred for laboratory testing. Six new TB cases were identified in this active case finding program, with a prevalence of 4%. CONCLUSION This study presents the first data on TB prevalence in a population of PWID in Tanzania. This prevalence is 23 times that of the general Tanzanian TB prevalence of 0.2%. These results have significant implications for TB control.

show abstract

“…However, none of these projects had parallel control groups, and instead were compared with routinely collected data from the year before. Hossain 2010 No parallel control group Kaboru 2013 No parallel control group Kakinda 2016 No parallel control group Khan 2007 No intervention to increase TB diagnosis Kuznetsov 2014 No parallel control group Lebina 2016 No parallel control group Ntinginya 2012 No parallel control group Oshi 2016 No parallel control group Prasad 2016 No parallel control group Pronyk 2001 Not a TB case‐finding study Ruutel 2011 Not a relevent comparison. This study screened intravenous drug users participating in a methadone substitution programme for TB.…”

Section: Characteristics Of Excluded Studies [Ordered By Study Id]mentioning

confidence: 99%

Interventions to increase tuberculosis case detection at primary healthcare or community-level services

Mhimbira

Cuevas

Dacombe

et al. 2017

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

BackgroundPulmonary tuberculosis is usually diagnosed when symptomatic individuals seek care at healthcare facilities, and healthcare workers have a minimal role in promoting the health-seeking behaviour. However, some policy specialists believe the healthcare system could be more active in tuberculosis diagnosis to increase tuberculosis case detection.ObjectivesTo evaluate the effectiveness of different strategies to increase tuberculosis case detection through improving access (geographical, financial, educational) to tuberculosis diagnosis at primary healthcare or community-level services.Search methodsWe searched the following databases for relevant studies up to 19 December 2016: the Cochrane Infectious Disease Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library, Issue 12, 2016; MEDLINE; Embase; Science Citation Index Expanded, Social Sciences Citation Index; BIOSIS Previews; and Scopus. We also searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, and the metaRegister of Controlled Trials (mRCT) for ongoing trials.Selection criteriaRandomized and non-randomized controlled studies comparing any intervention that aims to improve access to a tuberculosis diagnosis, with no intervention or an alternative intervention.Data collection and analysisTwo review authors independently assessed trials for eligibility and risk of bias, and extracted data. We compared interventions using risk ratios (RR) and 95% confidence intervals (CI). We assessed the certainty of the evidence using the GRADE approach.Main resultsWe included nine cluster-randomized trials, one individual randomized trial, and seven non-randomized controlled studies. Nine studies were conducted in sub-Saharan Africa (Ethiopia, Nigeria, South Africa, Zambia, and Zimbabwe), six in Asia (Bangladesh, Cambodia, India, Nepal, and Pakistan), and two in South America (Brazil and Colombia); which are all high tuberculosis prevalence areas.Tuberculosis outreach screening, using house-to-house visits, sometimes combined with printed information about going to clinic, may increase tuberculosis case detection (RR 1.24, 95% CI 0.86 to 1.79; 4 trials, 6,458,591 participants in 297 clusters, low-certainty evidence); and probably increases case detection in areas with tuberculosis prevalence of 5% or more (RR 1.52, 95% CI 1.10 to 2.09; 3 trials, 155,918 participants, moderate-certainty evidence; prespecified stratified analysis). These interventions may lower the early default (prior to starting treatment) or default during treatment (RR 0.67, 95% CI 0.47 to 0.96; 3 trials, 849 participants, low-certainty evidence). However, this intervention may have may have little or no effect on treatment success (RR 1.07, 95% CI 1.00 to 1.15; 3 trials, 849 participants, low-certainty evidence), and we do not know if there is an effect on treatment failure or mortality. One study investigated long-term prevalence in the community, but with no clea...

show abstract

Enhanced tuberculosis case detection among substitution treatment patients: a randomized controlled trial

Cited by 7 publications

References 14 publications

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania

Interventions to increase tuberculosis case detection at primary healthcare or community-level services

Contact Info

Product

Resources

About