Tuberculosis among nomads in Adamawa, Nigeria: outcomes from two years of active case finding

John, Stephen; Gidado, M.; Dahiru, Tahir; Fanning, Anne; Aj, Codlin; Creswell, Jacob

doi:10.5588/ijtld.14.0679

Cited by 42 publications

(53 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous studies, 16,17 our study found that Xpert performed well in community-based ACF, especially when compared with culture. Xpert detected all the culture M. tuberculosis -positive cases and yielded three additional diagnoses in a much shorter turnaround time.…”

Section: Discussionsupporting

confidence: 92%

“…16 Similarly, a study in Nigeria reported the detection of an additional 189 M. tuberculosis- positive cases by a follow-up Xpert test among 1685 individuals with at least two smear-negative results. 17 Xpert is a diagnostic test that can be run outside centralized laboratories by individuals with minimal technical expertise. 21 In our setting, Xpert proficiency was rapidly acquired by technicians at both sites with the help of a short training course.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the traditional assays, the Xpert ® MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) could potentially contribute to the detection of TB cases. Further to the WHO’s 2011 recommendation that Xpert be used as the initial assay in individuals with suspected PTB, 10 several studies have evaluated Xpert in conjunction with ACF in a variety of settings and populations, with a focus on human immunodeficiency virus infected persons and household contacts of TB cases; 11–15 however, incorporating Xpert into community-based screening in the general population has been explored by relatively few studies, 16,17 and has not been documented in China.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Community-based active case finding for tuberculosis in rural western China: a cross-sectional study

Chen

Yang

Gào

et al. 2017

int j tuberc lung dis

View full text Add to dashboard Cite

SUMMARY SETTING Current passive case finding strategies are not effective at identifying tuberculosis (TB) patients in rural China. OBJECTIVE To evaluate a community-based, active case finding (ACF) scheme in identifying symptomatic individuals with TB. DESIGN We conducted door-to-door household visits of all residents aged ⩾15 years at two rural sites to screen for TB symptoms. Individuals with symptoms were enrolled and asked to provide three sputum samples. All participants underwent chest X-ray, and microbiologic detection of Mycobacterium tuberculosis from sputum samples using microscopy, solid culture and Xpert® MTB/RIF was performed. RESULTS Among the 19 334 residents screened for TB symptoms, 865 (4.5%) reported having ⩾1 symptom. A total of 52 TB cases were detected, 11 of whom had microbiologic confirmation. Xpert identified all five M. tuberculosis culture-positive cases and yielded an additional three diagnoses. Prevalence of newly detected TB at the two sites through ACF was respectively 475 and 196 per 100 000 population. These estimates are respectively four and eight times, on average, higher than those identified through passive surveillance during the previous 5-year period for the two sites. CONCLUSION Community-based symptom screening followed by laboratory tests was found to be feasible and effective in increasing TB case finding in rural China.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Community-based active case finding for tuberculosis in rural western China: a cross-sectional study

Chen

Yang

Gào

et al. 2017

int j tuberc lung dis

View full text Add to dashboard Cite

show abstract

“…An Ethiopian study involving ACF and other interventions like ACSM, LED microscopy, contact tracing, isoniazid preventive therapy and treatment support showed better outcomes after implementation. 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].…”

Section: Introductionmentioning

confidence: 99%

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

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.

show abstract

“…In recognition of these challenges, the government of Nigeria has prioritized Xpert use for people with HIV, suspected DR-TB, and children. Since introduction of Xpert in Nigeria, the few available studies have focused on its diagnostic performance in non-HIV clinical settings [12, 13]. Understanding the role of Xpert in the diagnosis of HIV-associated TB, as well as its impact on treatment outcomes, is crucial given the high mortality associated with this condition.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study

et al. 2017

View full text Add to dashboard Cite

BackgroundXpert MTB/Rif (Xpert) is described as a game changer in tuberculosis (TB) control. We evaluated the impact of Xpert on diagnosis, time to treatment, and treatment outcome among patients with HIV associated TB in Nigeria.MethodsAdults with HIV being evaluated for pulmonary TB (PTB) were consecutively enrolled into the study cohort. At baseline, expectorated sputa were examined using Xpert and smear microscopy for Mycobacterium tuberculosis (MTB) and acid fast bacilli, respectively. Patients diagnosed with TB were followed-up until 6 months post TB diagnosis. TB was defined as sputum positive by smear microscopy, Xpert detection of MTB (bacteriologically confirmed case), or clinician diagnosed TB with initiation of full TB treatment (clinical diagnosis). Time to treatment was time from first clinic presentation for TB evaluation to initiation of TB treatment. We examined the proportion PTB patients with a positive Xpert result and compared time to TB treatment and outcome of TB treatment in patients based on sputum test results.ResultsA total of 310 adults with HIV were enrolled. The median CD4 cell count was 242 (interquartile range (IQR) 120–425) cells/mm3 and 88.1% were receiving antiretroviral therapy (ART). PTB was diagnosed in 76 (24.5%) patients, with 71 (93.4%) being bacteriologically confirmed. Among patients with PTB, 56 (73.7%) were Xpert positive. Median time to treatment was 5 (IQR 2–8) days and 12 (IQR 5–35) days in patient with and without Xpert positive results, respectively; p = 0.005. Overall 73.1% had symptom free survival at 6 months post PTB treatment initiation with no significant differences observed based on TB test method. 10 (14.9%) died within 6 months of TB treatment initiation. In analysis adjusted for age, sex, and mode of diagnosis (Xpert positive or negative), only ART use independently predicted mortality (AOR 0.10; 95% CI 0.01–0.93).ConclusionThe use of Xpert for routine care reduced time to PTB treatment, but did not improve survival in patients with HIV treated for susceptible PTB.

show abstract

Tuberculosis among nomads in Adamawa, Nigeria: outcomes from two years of active case finding

Abstract: Nomads in Nigeria have high TB rates, and active case-finding approaches may be useful in identifying and successfully treating them. Large-scale interventions in vulnerable populations can improve TB case detection.

Cited by 42 publications

References 0 publications

Community-based active case finding for tuberculosis in rural western China: a cross-sectional study

Community-based active case finding for tuberculosis in rural western China: a cross-sectional study

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

Evaluation of gene xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: A prospective cohort study

Contact Info

Product

Resources

About