Impact of socioeconomic status and living condition on latent tuberculosis diagnosis among the tribal population of Melghat: A cohort study

Kashyap, Rajpal S.; Nayak, Amit R.; Husain, Aliabbas A.; Shekhawat, Seema D.; Satav, Ashish; Jain, Ruchika; Raje, Dhananjay; Daginawala, Hatim F.; Taori, Girdhar M.

doi:10.4103/0970-2113.184868

Cited by 24 publications

(27 citation statements)

References 21 publications

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“…This could be due to the increasing mobility of HHC for work and livelihood thus increasing their exposure to both tuberculous and non-tuberculous mycobacteria in the environment or more recent exposure to TB as has been suggested in some studies [ 18 ]. In addition, a higher proportion of individuals with malnutrition or low body mass index, and absence of BCG vaccination scar showed positivity to TST, irrespective of the cut-off, similar to other high risk cohorts [ 20 , 21 ]. These could also be false positive TST due to environmental or non-tuberculous mycobacteria, commonly encountered with manual laborers or farmers, who form the majority of our population.…”

Section: Discussionsupporting

confidence: 62%

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Tuberculin skin test and QuantiFERON-Gold In Tube assay for diagnosis of latent TB infection among household contacts of pulmonary TB patients in high TB burden setting

et al. 2018

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BackgroundWorld Health Organization (WHO) recommends systematic screening of high-risk populations, including household contacts (HHCs) of adult pulmonary tuberculosis (TB) patients, as a key strategy for elimination of TB. QuantiFERON-TB Gold In-Tube (QFT-GIT) assay and tuberculin skin test (TST) are two commonly used tools for the detection of latent tuberculosis infection (LTBI) but may yield differential results, affecting eligibility for TB preventive therapy.Materials and methodsA prospective cohort study of adult pulmonary TB patients and their HHCs were recruited in 2 cities of India, Pune and Chennai. HHCs underwent QFT-GIT (QIAGEN) and TST (PPD SPAN 2TU/5TU). A positive QFT-GIT was defined as value ≥0.35 IU/ml and a positive TST as an induration of ≥5 mm. A secondary outcome of TST induration ≥10mm was explored. Proportion positive by either or both assays, discordant positives and negatives were calculated; test concordance was assessed using percentage agreement and kappa statistics; and risk factors for concordance and discordance including age categories were assessed using logistic regression. Sensitivity and specificity was estimated by latent class model.ResultsOf 1048 HHCs enrolled, 869 [median (IQR) age: 27 years (15–40)] had both TST and QFT-GIT results available and prevalence of LTBI by QFT-GIT was 54% [95% CI (51, 57)], by TST was 55% [95% CI (52, 58)], by either test was 74% [95% CI (71, 77) and by both tests was 35% [95% CI (31, 38)]. Discordance of TST+/QFT-GIT- was 21% while TST-/QFT-GIT+ was 26%. Poor to fair agreement occurred with TST 5mm or 10mm cutoff (60 and 61% agreement with kappa value of 0.20 and 0.25 respectively). Test agreement varied by age, TST strength and induration cut-off. In multivariate analysis, span PPD was a risk factor for QFT-GIT+ and TST- while absence of BCG scar was for TST+ and QFT-GIT-. Being employed and exposure to TB case outside the household case were associated with positivity by both the tests. Sensitivity of TST and QFT-GIT to diagnose LTBI was 77% and 69%. Probability of having LTBI was >90% when both tests were positive irrespective of exposure gradient.ConclusionPrevalence of LTBI among HHCs of adult pulmonary TB patients in India is very high and varies by test type, age, and exposure gradient. In our high TB burden setting, a strategy to treat all HHCs or a targeted strategy whereby an exposure index is used should be assessed in future preventive therapy and vaccine studies as HHCs have several factors that place them at high risk for progression to TB disease.

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Section: Discussionsupporting

confidence: 62%

“…These could also be false positive TST due to environmental or non-tuberculous mycobacteria, commonly encountered with manual laborers or farmers, who form the majority of our population. Poor socioeconomic status and living conditions have also been shown as strong risk factors linked with LTBI [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Tuberculin skin test and QuantiFERON-Gold In Tube assay for diagnosis of latent TB infection among household contacts of pulmonary TB patients in high TB burden setting

et al. 2018

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“…The expenditure for the components of TAP is as described below (Figure 2): 1) Patient honorarium: The proportion of expenditure ranged from 25% -60% with the utilization rate less than 33% in recent years 2) Sputum collection transport: The proportion of expenditure ranged from 19% -80% with the utilization rate less than 37% in recent years 3) Staff incentive: The proportion of expenditure ranged from 50% -76% with the utilization rate less than 56% in recent years 4) Vehicle maintenance: The proportion of expenditure ranged from 28% -60% with the utilization rate less than 48% in recent years…”

Section: Resultsmentioning

confidence: 99%

“…Globally, tuberculosis remains a major public health problem and India contributes to more than 27% of the TB burden [1]. It is evident that the tribal population is more affected with tuberculosis when compared to the general population [2] [3]. There are 104 million tribal people (8.6% of the population) in the country [4].…”

Section: Introductionmentioning

confidence: 99%

Revised National Tuberculosis Control Programme (RNTCP) Tribal Action Plan Fund Utilisation: How Does Chhattisgarh State in India Fare?

Mallick¹,

Nagaraja²,

Sagili³

et al. 2019

JTR

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Background: In India, tuberculosis remains as a major public health problem amongst the tribal population. Poor physical access to diagnosis and treatment under the Revised National TB control programme (RNTCP) still remains the problem for the population. RNTCP implements Tribal Action Plan (TAP) for tribal patients. We conducted the study to determine the trends of financial utilisation for the special provisions available under tribal action plan like patient honorarium, incentive for sputum collection and transport, incentive for programme staff and incentive for vehicle maintenance. Methods: A cross-sectional study based on mixed method study approach was conducted in Chhattisgarh, India during Nov. 16 to Jun. 17. District TB Officers implementing TAP were interviewed telephonically using a semi-structured questionnaire to ascertain and analyse the reasons for low fund utilization in their districts. Retrospective financial data for five financial years from 13 TAP districts for 2012-2013 to 2016-2017 was collected, compiled and analysed. Results: Overall, the trends on states expenditure on tribal action plan in terms of absolute numbers has increased over the past five years; however, in terms of fund utilization against received ranges from 37%-86% with the utilization rate less than 44% in the recent years (2014-2017). Conclusion: The trend of utilisation of TAP is less than 44% over the recent years. There is an urgent need for the administrators to intervene and improve the efficiency of fund utilisation at State

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“…Tuberculosis (TB) is a signi icant public health concern globally and the world's second most common cause of death from infectious disease after HIV/AIDS [1,2]. Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis (MTB) that usually affects the lungs leading to severe cough, fever, and chest pains.…”

Section: Introductionmentioning

confidence: 99%

The role of clinical pharmacist in enhancing the health-related quality of life in patients with pulmonary tuberculosis

Varghese¹,

Poulose²,

G³

et al. 2020

ijrls

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Tuberculosis (TB) is potentially airborne severe infectious disease which requires long term treatment. It considerably affects the physical and mental health quality of the patient’s life. Appropriate patient counselling with the help of Patient Information Leaflet will help to improve the patient’s quality of life and overall treatment outcome. To enhance the health related quality of life in pulmonary tuberculosis patients by providing patient counselling with the aid of patient information leaflet. An interventional study was carried out for six months in 80 patients diagnosed with pulmonary tuberculosis from the OP & IP of Tuberculosis and Chest Department of a medical college hospital. The HRQoL was assessed using the SF-36 questionnaire. Appropriate patient counselling was provided with the help of Patient Information Leaflet. In our study, a total of 80 patients were enrolled, out of which 49[61%] were Out-patients, and 31[39%] were In-patients. All the 8 sub domains of the SF-36 survey show statistical significance with improvement in 2nd Visit (after counselling) when compared with the baseline visit. The demographic variables like smoking, low socioeconomic status, allergies, family history show statistically significant association with overall HRQoL. The HRQOL of the pulmonary tuberculosis patients were initially low before the start of Anti-TB therapy, after providing proper patient counselling using patient information leaflet the HRQoL scores were found to be increased on the subsequent re-visits, which implies the need of proper patient counselling and follow-up in PTB for the better quality of life.

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Impact of socioeconomic status and living condition on latent tuberculosis diagnosis among the tribal population of Melghat: A cohort study

Cited by 24 publications

References 21 publications

Tuberculin skin test and QuantiFERON-Gold In Tube assay for diagnosis of latent TB infection among household contacts of pulmonary TB patients in high TB burden setting

Tuberculin skin test and QuantiFERON-Gold In Tube assay for diagnosis of latent TB infection among household contacts of pulmonary TB patients in high TB burden setting

Revised National Tuberculosis Control Programme (RNTCP) Tribal Action Plan Fund Utilisation: How Does Chhattisgarh State in India Fare?

The role of clinical pharmacist in enhancing the health-related quality of life in patients with pulmonary tuberculosis

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