Tuberculosis case-finding in Western Australia

Pang, S.C.; Harrison, Richard H.; Clayton, A. S.; Mercer, J.; Brearley, J.C.

doi:10.1016/s0954-6111(05)80349-x

Cited by 4 publications

(7 citation statements)

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“…Although side-effects from INH are uncommon, addressing even minor ones and re-assuring caregivers may improve retention of contacts receiving IPT. [34] The WHO and NDoH recommend a 6-month course of INH to prevent TB in child contacts; [22,25] however, adherence rates are poor with this regimen. [10,11,15] Contacts in this study collected IPT for a median (IQR) number of 8 (11.25) weeks.…”

Section: Researchmentioning

confidence: 99%

An assessment of the isoniazid preventive therapy programme for children in a busy primary healthcare clinic in Nelson Mandela Bay Health District, Eastern Cape Province, South Africa

2018

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Despite contacts being well documented, child contacts were poorly identified. The fall-out of children at each step from identification to IPT completion was unacceptably high. Contacts of male patients and retreatment index patients were at greater risk of poor management. Recommendations to improve IPT delivery at national and local level include a review of the national IPT guidelines, considering the relative success of shorter courses of TB prophylaxis, the use of standardised IPT stationery, staff training and the involvement of community health workers in contact management.

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Section: Researchmentioning

confidence: 99%

An assessment of the isoniazid preventive therapy programme for children in a busy primary healthcare clinic in Nelson Mandela Bay Health District, Eastern Cape Province, South Africa

2018

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“…Wide variations exist regarding the meaning and time frame of “follow-up.” In countries that perform pre-entry screening (e.g., US, Australia, Canada, and Israel), “follow-up” describes the first contact of a local or regional health body with the immigrant after migration [ 13 , 14 , 22 , 44 ]. In these countries, the follow-up refers to the time period between pre-entry screening in the country of origin and first contact in the country of destination.…”

Section: Resultsmentioning

confidence: 99%

“…In these countries, the follow-up refers to the time period between pre-entry screening in the country of origin and first contact in the country of destination. The first contact was not carried out in a fixed time interval, but was reported to be carried out as soon as possible after arrival (Canada: mean 61 days [ 44 ], Australia: “within 4 weeks” [ 13 ]. While some, such as the US and the UK, perform a “one-time” follow-up, and then leave it to the discretion of the medical staff to treat or follow-up on migrants with diagnosed disease or infection, other countries, such as Israel, Australia, or Canada dispose of a follow-up period, during which all previously identified migrants are followed in various visits.…”

Section: Resultsmentioning

confidence: 99%

“…Coverage, i.e., the proportion of migrants taking up screening among all migrants identified as eligible, was reported for 20 cohorts (see Fig 2 and Table 2 ). The reported coverage ranged from 41% in 1 study from the UK [ 12 ] to 100% in a study from Australia [ 13 ] and Israel [ 14 ] with 17 cohorts ranging between a coverage 45 and 85%. Overall coverage was higher than 60% in 15 studies, and tended to be lower in voluntary compared to compulsory programmes, and higher in studies from the USA, Israel and Australia.…”

Section: Resultsmentioning

confidence: 99%

“…The “eligible-population-yield” of the different screening programmes varied by more than factor 100 and ranged between 53.05 (31.94 to 82.84) in a Dutch study [ 15 ] to 5,927 per 100,000 (4,248.29 to 8,013.71) in a US study [ 16 ] (see Table 2 and Fig 3 ). Of 15 estimates with narrow 95% CIs for yields (i.e., 95% CIs with uncertainty ranges less than 1,000 cases per 100,000) [ 12 , 13 , 15 , 17 – 26 ], 12 were below 1,500 cases per 100,000 eligible migrants ( Fig 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Mandatory, voluntary, repetitive, or one-off post-migration follow-up for tuberculosis prevention and control: A systematic review

et al. 2023

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Background Post-migration follow-up of migrants identified to be at-risk of developing tuberculosis during the initial screening is effective, but programmes vary across countries. We aimed to review main strategies applied to design follow-up programmes and analyse the effect of key programme characteristics on reported coverage (i.e., proportion of migrants screened among those eligible for screening) or yields (i.e., proportion of active tuberculosis among those identified as eligible for follow-up screening). Methods and findings We performed a systematic review and meta-analysis of studies reporting yields of follow-up screening programmes. Studies were included if they reported the rate of tuberculosis disease detected in international migrants through active case finding strategies and applied a post-migration follow-up (defined as one or more additional rounds of screening after finalising the initial round). For this, we retrieved all studies identified by Chan and colleagues for their systematic review (in their search until January 12, 2017) and included those reporting from active follow-up programmes. We then updated the search (from January 12, 2017 to September 30, 2022) using Medline and Embase via Ovid. Data were extracted on reported coverage, yields, and key programme characteristics, including eligible population, mode of screening, time intervals for screening, programme providers, and legal frameworks. Differences in follow-up programmes were tabulated and synthesised narratively. Meta-analyses in random effect models and exploratory analysis of subgroups showed high heterogeneity (I2 statistic > 95.0%). We hence refrained from pooling, and estimated yields and coverage with corresponding 95% confidence intervals (CIs), stratified by country, legal character (mandatory versus voluntary screening), and follow-up scheme (one-off versus repetitive screening) using forest plots for comparison and synthesis. Of 1,170 articles, 24 reports on screening programmes from 7 countries were included, with considerable variation in eligible populations, time intervals of screening, and diagnostic protocols. Coverage varied, but was higher than 60% in 15 studies, and tended to be lower in voluntary compared to compulsory programmes, and higher in studies from the United States of America, Israel, and Australia. Yield varied within and between countries and ranged between 53.05 (31.94 to 82.84) in a Dutch study and 5,927.05 (4,248.29 to 8,013.71) in a study from the United States. Of 15 estimates with narrow 95% CIs for yields, 12 were below 1,500 cases per 100,000 eligible migrants. Estimates of yields in one-off follow-up programmes tended to be higher and were surrounded by less uncertainty, compared to those in repetitive follow-up programmes. Yields in voluntary and mandatory programmes were comparable in magnitude and uncertainty. The study is limited by the heterogeneity in the design of the identified screening programmes as effectiveness, coverage and yields also depend on factors often underreported or not known, such as baseline incidence in the respective population, reactivation rate, educative and administrative processes, and consequences of not complying with obligatory measures. Conclusion Programme characteristics of post-migration follow-up screening for prevention and control of tuberculosis as well as coverage and yield vary considerably. Voluntary programmes appear to have similar yields compared with mandatory programmes and repetitive screening apparently did not lead to higher yields compared with one-off screening. Screening strategies should consider marginal costs for each additional round of screening.

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Chest radiography and tuberculosis case-finding in Western Australia

Pang¹

1998

Respiratory Medicine

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Tuberculosis case-finding in Western Australia

Cited by 4 publications

References 10 publications

An assessment of the isoniazid preventive therapy programme for children in a busy primary healthcare clinic in Nelson Mandela Bay Health District, Eastern Cape Province, South Africa

An assessment of the isoniazid preventive therapy programme for children in a busy primary healthcare clinic in Nelson Mandela Bay Health District, Eastern Cape Province, South Africa

Mandatory, voluntary, repetitive, or one-off post-migration follow-up for tuberculosis prevention and control: A systematic review

Chest radiography and tuberculosis case-finding in Western Australia

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