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Strategic response to COVID-19 in Ethiopia. 埃塞俄比亚 COVID-19 的战略对策。
IF 1.4 Pub Date : 2022-12-21 DOI: 10.5588/pha.22.0007
D K Huluka, A W Ashagrie, T H Gebremariam, H Y Ahmed, R A Kebede, A B Binegdie, K G Gebrehiwot, M Tadesse, M Sultan, W W Dode, A A Tumebo, A Abayneh, Y Seman, T Firew, C B Sherman, N W Schluger, D A Haisch

COVID-19, the novel coronavirus, has posed a major threat to low- and middle-income countries (LMICs) due to inadequate health infrastructure and human resources. Ethiopia, a low-income country with the second largest population in Africa, has coordinated a strategic response, leveraging existing infrastructure and health systems and mobilizing public health professionals and specialist expert physicians for a multifaceted, unified government approach and adaptive response. Resource limitations, particularly in critical care, have still posed challenges, but the public health and clinical interventions thus far have prevented the catastrophic toll that many predicted. As the pandemic continues, Ethiopia expects to use a triple care model integrated at all levels, consisting of COVID-19 care, isolation care for suspected cases, and essential health services, and urges intensified non-pharmaceutical interventions alongside equitable global vaccine distribution as the ultimate answers to pandemic control. This paper draws on existing data, national planning and guidelines, and expertise from health leadership to describe this response in hopes of providing an example of how future large-scale health challenges might be faced in LMICs, using Ethiopia's successes and challenges in facing the pandemic.

由于卫生基础设施和人力资源不足,新型冠状病毒 COVID-19 已对中低收入国家(LMIC)构成重大威胁。埃塞俄比亚是非洲第二大人口众多的低收入国家,该国利用现有的基础设施和卫生系统,动员公共卫生专业人员和专科专家医生,采取多方面、统一的政府方法和适应性应对措施,协调采取了战略应对措施。资源限制,尤其是重症护理方面的资源限制,仍然构成了挑战,但迄今为止的公共卫生和临床干预措施避免了许多人预测的灾难性伤亡。随着疫情的持续,埃塞俄比亚预计将在各个层面采用三重护理模式,包括 COVID-19 护理、疑似病例隔离护理和基本医疗服务,并敦促加强非药物干预措施,同时在全球范围内公平分配疫苗,以此作为控制疫情的最终解决方案。本文借鉴了现有数据、国家规划和指导方针以及卫生领导层的专业知识,描述了这一应对措施,希望通过埃塞俄比亚在面对大流行病时取得的成功和面临的挑战,为低收入与中等收入国家未来如何应对大规模卫生挑战提供一个范例。
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引用次数: 0
Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents. 对改善儿童和青少年艾滋病治疗效果的干预措施进行过程评估。
IF 1.3 Q4 RESPIRATORY SYSTEM Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0009
M Seguin, S Dringus, S Chiomvu, T Apollo, E Sibanda, V Simms, S Bernays, R Chikodzore, N Redzo, P Mlilo, L Ndlovu, P Nzombe, B Ncube, K Kranzer, R Abbas Ferrand, C D Chikwari

Setting: Children and adolescents with HIV encounter challenges in initiation and adherence to antiretroviral therapy (ART). A community-based support intervention of structured home visits, aimed at improving initiation, adherence and treatment, was delivered by community health workers (CHWs) to children and adolescents newly diagnosed with HIV.

Objectives: To 1) describe intervention delivery, 2) explore CHW, caregiver and adolescents' perceptions of the intervention, 3) identify barriers and facilitators to implementation, and 4) ascertain treatment outcomes at 12 months' post-HIV diagnosis.

Design: We drew upon: 1) semi-structured interviews (n = 22) with 5 adolescents, 11 caregivers and 6 CHWs, 2) 28 CHW field manuals, and 3) quantitative data for study participants (demographic information and HIV clinical outcomes).

Results: Forty-one children received at least a part of the intervention. Of those whose viral load was tested, 26 (n = 32, 81.3%) were virally suppressed. Interviewees felt that the intervention supported ART adherence and strengthened mental health. Facilitators to intervention delivery were convenience and rapport between CHWs and families. Stigma, challenges in locating participants and inadequate resources for CHWs were barriers.

Conclusion: This intervention was helpful in supporting HIV treatment adherence among adolescents and children. Facilitators and barriers may be useful in developing future interventions.

环境:感染艾滋病病毒的儿童和青少年在开始和坚持抗逆转录病毒疗法(ART)方面遇到了挑战。社区卫生工作者(CHWs)为新诊断出感染艾滋病病毒的儿童和青少年提供了一项基于社区的支持性干预措施,即有组织的家访,旨在改善启动、坚持和治疗情况:目的:1)描述干预措施的实施情况;2)探讨社区保健员、护理人员和青少年对干预措施的看法;3)确定实施的障碍和促进因素;4)确定艾滋病毒确诊后 12 个月的治疗结果:设计:我们采用了以下方法1) 对 5 名青少年、11 名照顾者和 6 名儿童保健工作者进行的半结构式访谈(n = 22);2) 28 份儿童保健工作者实地手册;3) 研究参与者的定量数据(人口统计学信息和 HIV 临床结果):结果:41 名儿童至少接受了部分干预。在接受病毒载量检测的儿童中,有 26 人(n = 32,81.3%)的病毒得到抑制。受访者认为,干预有助于坚持抗逆转录病毒疗法,并能增强心理健康。社区保健工作者和家庭之间的便利和融洽关系是实施干预的有利因素。而污名化、寻找参与者方面的挑战以及社区保健员资源不足则是障碍:这项干预措施有助于支持青少年和儿童坚持接受艾滋病治疗。促进因素和障碍可能有助于制定未来的干预措施。
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引用次数: 0
Early interactions with newly diagnosed TB patients in hospital can support linkage to care. 与医院中新诊断的结核病患者的早期互动可以支持与护理的联系。
IF 1.4 Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0012
L Viljoen, P Hendricks, G Hoddinott, N Vanqa, M Osman, A C Hesseling, S-A Meehan

Background: In South Africa, failure to link individuals diagnosed with TB to care remains an important gap in the TB care cascade. Compared to people diagnosed at primary healthcare (PHC) facilities, people diagnosed in hospitals are more likely to require additional support to be linked with PHC TB treatment services. We describe a patient interaction process to support linkage to TB care.

Methods: We implemented a step-by-step early patient interaction process with 84 adults newly diagnosed with TB in one district hospital in Khayelitsha, Cape Town, South Africa (August 2020-March 2021). We confirmed patient contact details, provided TB and health information, shared information on accessing care at PHC facilities and answered patients' questions in their home language.

Results: Most patients (54/84, 64%) provided updated telephone numbers, and 19/84 (23%) reported changes in their physical address. Patients welcomed practical and health information in their home language. The majority (74/84, 88%) were linked to care after hospital discharge.

Conclusions: A simple early patient interaction process implemented as part of routine care is a feasible strategy to facilitate early TB treatment initiation and registration.

背景:在南非,未能将结核病患者与治疗联系起来仍然是结核病治疗梯级中的一个重要差距。与在初级卫生保健机构诊断的人相比,在医院诊断的人更有可能需要额外的支持,以便与初级卫生保健结核病治疗服务联系起来。我们描述了一个患者互动过程,以支持与结核病护理的联系。方法:我们在南非开普敦Khayelitsha的一家地区医院对84名新诊断为结核病的成年人实施了逐步的早期患者互动过程(2020年8月至2021年3月)。我们确认了患者的联系方式,提供了结核病和健康信息,分享了在初级保健机构获得护理的信息,并用患者的母语回答了他们的问题。结果:大多数患者(54/ 84,64%)提供了更新的电话号码,19/84(23%)报告了其实际地址的变化。病人欢迎用他们的母语提供实用和健康的信息。大多数(74/84,88%)与出院后的护理有关。结论:作为常规护理的一部分,实施简单的早期患者互动过程是促进早期结核病治疗启动和登记的可行策略。
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引用次数: 1
Assessment of TB underreporting by level of reporting system in Lagos, Nigeria. 尼日利亚拉各斯按报告系统级别对结核病漏报情况的评估。
IF 1.4 Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0008
M Gidado, E M H Mitchell, A O Adejumo, J Levy, O Emperor, A Lawson, N Chukwueme, H Abdur-Razak, A Idris, A Adebowale

Background: Nigeria has an estimated TB prevalence of 219 per 100,000 population. In 2019, Nigeria diagnosed and notified 27% of the WHO-estimated cases of all forms of TB and contributed 11% of the missing TB cases globally.

Objective: To assess TB underreporting by type and level of health facility (HF), and associated factors in Lagos State, Nigeria.

Methodology: Quantitative secondary data analysis of TB cases was conducted in 2015. χ2 test was used to assess the association between treatment initiation, TB underreporting, local government area (LGA) and HF characteristics.

Results: Overall, 2,064 persons with bacteriologically confirmed TB (15.5%) were not matched to patients in sampled TB registers. Treatment status was unknown for 86 cases (IQR 55-97) per LGA. LGAs with higher case-loads had higher proportions of cases with unknown TB status. Discrepant reporting of treated TB was also common (60% HFs). Primary-level TB treatment facilities and unengaged private facilities were less likely to notify.

Conclusion: There was TB under-reporting across all types and levels of HFs and LGAs. There is a need to revise or strengthen the process of supervision and data quality assurance system at all levels.

背景:尼日利亚的结核病患病率估计为每10万人中有219人。2019年,尼日利亚诊断并通报了世卫组织估计的所有形式结核病病例的27%,占全球失踪结核病病例的11%。目的:评估尼日利亚拉各斯州按卫生设施类型和水平及其相关因素划分的结核病漏报情况。方法:对2015年结核病病例进行定量二次数据分析。采用χ2检验评估治疗开始、结核病漏报、地方政府面积(LGA)与HF特征之间的相关性。结果:总体而言,2,064名细菌学证实的结核病患者(15.5%)与抽样结核病登记册中的患者不匹配。每个LGA有86例(IQR 55-97)的治疗状况未知。病例负荷较高的地方行政区,结核病状况不明的病例比例较高。治疗后结核病的差异报告也很常见(60%的HFs)。初级结核病治疗机构和未参与的私人机构通报的可能性较低。结论:在所有类型和水平的HFs和LGAs中都存在结核病漏报。有必要修改或加强各级过程监督和数据质量保证体系。
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引用次数: 3
The need to address the impact of COVID-19 on TB control for vulnerable groups. 需要解决COVID-19对弱势群体结核病控制的影响。
IF 1.4 Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0022
Z Aranda, H J Sánchez-Pérez
D Editor, We would like to call on health providers, researchers and decision-makers to develop studies and interventions that address the impact of COVID-19 on TB control in vulnerable populations. This is inspired by the recent article by Dheda and colleagues in the Lancet Respiratory Medicine,1 in which the authors describe the effects of the pandemic on TB control at the global and national levels, but without acknowledging the heterogeneous impact among populations with different sociodemographic characteristics. Alarmed by this omission, we wanted to highlight the need to address the particularly marked impact of COVID-19 on TB care for vulnerable groups. This is exemplified by the current situation affecting indigenous and migrant populations living in the state of Chiapas, Mexico. Chiapas is the southernmost state of Mexico, neighbouring Guatemala. The state has the second highest proportion of speakers of indigenous languages in the country (28.2%),2 and serves as an entry point into Mexico for thousands of migrants each year, mainly from Central America and the Caribbean, with 70% of all national refugee applications concentrated in a single municipality.3 The migrant population in Chiapas has almost doubled over the past 10 years due to political instability, social violence, natural disasters and economic hardship – aggravated by the COVID-19 pandemic – in their countries of origin. In 2018, indigenous populations among the citizens of Chiapas had the highest levels of poverty (above 90%) and lack of access to health services (above 20%),2 exacerbated by widespread racism and a lack of cultural competence among health providers. In the case of migrant populations, almost half had left their home countries due to economic issues and less than 50% had received healthcare when needed.4 It is well known that poorer living conditions, hygiene and health support among indigenous and migrant citizens lead to increased susceptibility to TB, and poorer diagnosis, management and prognosis of the disease in these populations. On top of this, the COVID-19 pandemic has increased economic hardship and limited access to health services for vulnerable groups in Chiapas, who have been disproportionately affected by the COVID-19 disease burden, thereby worsening the state of TB and TB care among indigenous peoples and migrants. For example, TB case detection in indigenous populations declined by 50% from 2019 to 2020 in one of 15 regions in Chiapas, compared to a 30% decrease in the general population.5 This example highlights the importance of gathering evidence on the specific effect of the COVID-19 pandemic on TB control in vulnerable groups. This is often overshadowed by national-level data and demonstrates the need to develop intersectoral interventions to tackle the social determinants that increase susceptibility to TB and impede access to TB care among populations that are particularly affected by the pandemic.
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引用次数: 0
IPT coverage and determinants of care coverage in Tanzania. 坦桑尼亚IPT覆盖率和保健覆盖率的决定因素。
IF 1.4 Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0018
H Manisha, W Amani, A Garrib, M Senkoro, S Mfinanga

Background: TB is a major cause of mortality worldwide, with the highest risk in people living with HIV/AIDS (PLWHA). Isoniazid preventive therapy (IPT), in combination with antiretroviral therapy (ART), reduces the overall incidence and mortality from TB by up to 90% among PLWHA. Tanzania has limited published data on IPT coverage among PLWHA.

Objective: To investigate coverage and determinants of IPT among PLWHA receiving care in selected care and treatment clinics in Dar es Salaam, Tanzania.

Methods: An analytical cross-sectional design to study 31,480 HIV-positive adults. Proportions and comparisons were obtained using χ2 tests, while determinants for IPT were assessed using adjusted multivariable analysis.

Results: The IPT coverage among eligible PLWHA was generally low (28.9%), with increased coverage over time. The determinants for IPT coverage included age >36 years, having WHO Clinical Stages 1 and 2 compared to 3 and 4, and having normal weight, or being overweight and obesity compared to underweight.

Conclusion: IPT coverage in Dar es Salaam is very low; individuals with minor HIV disease severity were more likely to initiate IPT. This shows a possible gap in the prescribing practices among healthcare providers. More efforts to ensure IPT coverage implementation in Dar es Salaam are required.

背景:结核病是世界范围内死亡的主要原因之一,艾滋病毒/艾滋病(PLWHA)感染者的风险最高。异烟肼预防治疗与抗逆转录病毒治疗相结合,可将艾滋病感染者结核病的总发病率和死亡率降低高达90%。坦桑尼亚公布的关于艾滋病病毒携带者间IPT覆盖率的数据有限。目的:调查在坦桑尼亚达累斯萨拉姆选定的护理和治疗诊所接受治疗的PLWHA患者中IPT的覆盖率和决定因素。方法:采用横断面分析设计对31480名hiv阳性成人进行研究。采用χ2检验获得比例和比较,采用调整后的多变量分析评估IPT的决定因素。结果:在符合条件的艾滋病感染者中,IPT覆盖率普遍较低(28.9%),随着时间的推移覆盖率有所提高。IPT覆盖率的决定因素包括年龄>36岁,与3期和4期相比具有世卫组织临床1期和2期,体重正常,或与体重不足相比超重和肥胖。结论:达累斯萨拉姆IPT覆盖率很低;HIV疾病严重程度较轻的个体更有可能开始IPT。这表明在医疗保健提供者之间的处方做法可能存在差距。需要作出更多努力,确保在达累斯萨拉姆实施IPT。
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引用次数: 1
Improving TB case notification and treatment coverage through data use. 通过数据使用改善结核病病例通报和治疗覆盖率。
IF 1.4 Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0001
O O Chijioke-Akaniro, E Ubochioma, A Omoniyi, O Fashade, O Olarewaju, S Asuke, E C Aniwada, A N Uwaezuoke, J Sseskitooleko, N Workneh, E Masini, B Morris, A Lawanson, C Anyaike

Background: This was a study on national TB data.

Objective: To assess improvement in TB case notification and treatment coverage through improved data use for action in Nigeria.

Design: We analysed pre- and post-intervention secondary TB programme data comprising data on increased supervisory visits, incentives for health workers, DOTS expansion, outreaches and geo-code monitoring. Trend analysis was performed using Cochran-Armitage χ2 test for linear trends.

Results: Case-finding increased from 104,904 cases in 2017 to 138,591 in 2020. There was an increase of 2.0% from 2017 to 2018, 13.0% in 2018 to 2019 and 15.0% in 2019 to 2020 (P < 0.001). Facility DOTS coverage increased from 7,389 facilities in 2017 to 17,699 in 2020. There was an increase of 30.0% in 2018, 31.0% in 2019 and 40.0% in 2020 (P < 0.001). The number of reporting facilities increased from 5,854 in 2017 to 12,775 in 2020. Compared with 2017, there were an increase of 20.0% in 2018, 38.0% in 2019 and 32.0% in 2020 (P < 0.001). Treatment coverage rate increased from 24% in 2018 to 27% in 2019 and 30% in 2020.

Conclusion: TB service expansion, improved monitoring and the use of data for decision making are key in increasing TB treatment coverage.

背景:这是一项关于国家结核病数据的研究。目的:通过改进数据使用来评估尼日利亚结核病病例报告和治疗覆盖率的改善情况。设计:我们分析了干预前和干预后的继发性结核病规划数据,包括增加监督访问、卫生工作者激励、DOTS扩展、外展和地理编码监测的数据。对线性趋势采用Cochran-Armitage χ2检验进行趋势分析。结果:病例发现从2017年的104,904例增加到2020年的138,591例。2017 - 2018年增长2.0%,2018 - 2019年增长13.0%,2019 - 2020年增长15.0% (P < 0.001)。DOTS覆盖范围从2017年的7389个设施增加到2020年的17699个设施。2018年增长30.0%,2019年增长31.0%,2020年增长40.0% (P < 0.001)。报告设施从2017年的5854个增加到2020年的12775个。与2017年相比,2018年增长20.0%,2019年增长38.0%,2020年增长32.0% (P < 0.001)。治疗覆盖率从2018年的24%提高到2019年的27%和2020年的30%。结论:扩大结核病服务、改进监测和利用数据进行决策是提高结核病治疗覆盖率的关键。
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引用次数: 0
Knowledge and attitudes towards TB among healthcare workers in Yogyakarta, Indonesia. 印度尼西亚日惹医护人员对结核病的认识和态度。
IF 1.3 Q4 RESPIRATORY SYSTEM Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0017
S Main, B Dwihardiani, A Hidayat, S Khodijah, J Greig, G Chan, A E Parry, B Nababan, I Billy, P du Cros, R Triasih

Setting: Healthcare workers (HCWs) are at an increased risk of TB worldwide. Individual knowledge and attitudes may influence HCW behaviour, and subsequently, TB risk. Indonesia has the second highest case-load globally.

Objective: To measure TB knowledge and attitudes among a subsection of HCWs in Yogyakarta, Indonesia, and to explore factors associated with knowledge.

Design: A cross-sectional study using an online survey targeting all HCW staff was conducted among HCWs from four pre-selected healthcare facilities in Yogyakarta. Descriptive analysis and a multivariable linear regression were undertaken.

Results: Of 792 HCWs, 290 (37%) completed the survey; 64% (n = 185) were medical staff, 33% (n = 95) reported previously being tested for active TB and 8% (n = 24) for latent TB. The mean knowledge score was 7.2/11 (SD 1.5): this was higher among medical staff and those with university education (average score increase: 0.53, 95% CI 0.15 to 0.90; and 0.38, 95% CI 0.01 to 0.74, respectively). Participants agreed that free access to TB screening (93%) and treatment (93%) should be available, and 57% of medical and 77% of non-medical staff would take preventive therapy if eligible.

Conclusion: Participants had practical understanding of TB; however, gaps were identified in knowledge about TB disease progression and prevention. Prevention programmes were viewed positively. We suggest further TB education and engagement programmes for HCWs.

背景:在全球范围内,医护人员(HCWs)罹患肺结核的风险都在增加。个人的知识和态度可能会影响医护人员的行为,进而影响结核病风险。印度尼西亚是全球病例数第二高的国家:测量印尼日惹部分高危卫生工作者的结核病知识和态度,并探讨与知识相关的因素:设计:在日惹四个预选医疗机构的医护人员中开展了一项横断面研究,采用在线调查的方式对所有医护人员进行调查。研究进行了描述性分析和多变量线性回归:在 792 名医护人员中,有 290 人(37%)完成了调查;64%(n = 185)为医务人员,33%(n = 95)称曾接受过活动性肺结核检测,8%(n = 24)称曾接受过潜伏性肺结核检测。平均知识得分为 7.2/11(标准差 1.5):医务人员和受过大学教育的人员得分更高(平均得分增加了 0.53,95% CI):平均得分分别增加了 0.53,95% CI 0.15 至 0.90;以及 0.38,95% CI 0.01 至 0.74)。参与者同意应提供免费的结核病筛查(93%)和治疗(93%),57%的医务人员和 77%的非医务人员会在符合条件的情况下接受预防性治疗:结论:参与者对结核病有切实的了解,但在结核病进展和预防方面的知识存在差距。预防计划得到了积极的评价。我们建议针对医护人员进一步开展结核病教育和参与计划。
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引用次数: 0
Remembering Donald A. Enarson. 记住唐纳德·a·埃纳森。
IF 1.4 Pub Date : 2022-09-21 DOI: 10.5588/ijtld.22.0048
G N Kazi
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引用次数: 0
Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria. 便携式数字x射线在尼日利亚农村社区用于结核病诊断前筛查。
IF 1.4 Pub Date : 2022-06-21 DOI: 10.5588/pha.21.0079
B Odume, E Chukwu, T Fawole, N Nwokoye, C Ogbudebe, O Chukwuogo, S Useni, C Dim, E Ubochioma, D Nongo, R Eneogu, T Lagundoye Odusote, O Oyelaran, C Anyaike

Setting: This pilot project was conducted in hard-to-reach communities of two Niger Delta States in the South-South Region of Nigeria.

Objective: To assess the usefulness of portable digital X-ray, the Delft-Light Backpack (DLB) for TB active case-finding (ACF) in hard-to-reach Niger Delta communities using the WHO 3B TB screening/diagnosis algorithm.

Design: DLB X-ray was used to screen all consenting eligible participants during community TB screening out-reaches in all hard-to-reach communities of Akwa Ibom and Cross River States in the Niger Delta, Nigeria. Participants with a CAD4TB (computer-aided detection for TB score) ⩾60 had Xpert (sputum) and/or clinical (radiograph) assessment for TB diagnosis. Data from the project were analysed for this study.

Results: A total of 8,230 participants (males: 47.2%, females: 52.8%) underwent TB screening and 1,140 (13.9%) presumptive TB cases were identified. The TB prevalence among all participants and among those with presumptive TB were respectively 1.2% and 8.6%. The number needed to screen was 84. Among people with presumptive TB, the proportion of males and females with confirmed TB was respectively 12.0% and 5.6% (P < 0.001).

Conclusion: TB screening using DLB X-ray during community-based ACF in hard-to-reach Niger Delta communities of Nigeria showed a high TB prevalence among participants. Nationwide deployment of the instrument in hard-to-reach areas is recommended.

环境:该试点项目在尼日利亚南南地区两个尼日尔三角洲州难以到达的社区开展。目的:评估便携式数字x线,Delft-Light Backpack (DLB)在难以到达的尼日尔三角洲社区使用WHO 3B结核病筛查/诊断算法进行结核病活动性病例发现(ACF)的有效性。设计:DLB x射线用于在尼日利亚尼日尔三角洲阿夸伊博姆州和克罗斯河州所有难以到达的社区结核病筛查外展活动中筛查所有同意的合格参与者。CAD4TB(计算机辅助检测结核病评分)大于或等于60的参与者进行了结核病诊断的Xpert(痰液)和/或临床(x光片)评估。本研究分析了该项目的数据。结果:共有8230名参与者(男性:47.2%,女性:52.8%)接受了结核病筛查,鉴定出1140例(13.9%)推定结核病病例。所有参与者和推定结核病患者的结核病患病率分别为1.2%和8.6%。需要筛选的人数是84人。在推定结核病患者中,男性和女性确诊结核病的比例分别为12.0%和5.6% (P < 0.001)。结论:在尼日利亚难以到达的尼日尔三角洲社区,社区ACF期间使用DLB x射线进行结核病筛查显示参与者中结核病患病率很高。建议在难以到达的地区在全国范围内部署该仪器。
{"title":"Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria.","authors":"B Odume,&nbsp;E Chukwu,&nbsp;T Fawole,&nbsp;N Nwokoye,&nbsp;C Ogbudebe,&nbsp;O Chukwuogo,&nbsp;S Useni,&nbsp;C Dim,&nbsp;E Ubochioma,&nbsp;D Nongo,&nbsp;R Eneogu,&nbsp;T Lagundoye Odusote,&nbsp;O Oyelaran,&nbsp;C Anyaike","doi":"10.5588/pha.21.0079","DOIUrl":"https://doi.org/10.5588/pha.21.0079","url":null,"abstract":"<p><strong>Setting: </strong>This pilot project was conducted in hard-to-reach communities of two Niger Delta States in the South-South Region of Nigeria.</p><p><strong>Objective: </strong>To assess the usefulness of portable digital X-ray, the Delft-Light Backpack (DLB) for TB active case-finding (ACF) in hard-to-reach Niger Delta communities using the WHO 3B TB screening/diagnosis algorithm.</p><p><strong>Design: </strong>DLB X-ray was used to screen all consenting eligible participants during community TB screening out-reaches in all hard-to-reach communities of Akwa Ibom and Cross River States in the Niger Delta, Nigeria. Participants with a CAD4TB (computer-aided detection for TB score) ⩾60 had Xpert (sputum) and/or clinical (radiograph) assessment for TB diagnosis. Data from the project were analysed for this study.</p><p><strong>Results: </strong>A total of 8,230 participants (males: 47.2%, females: 52.8%) underwent TB screening and 1,140 (13.9%) presumptive TB cases were identified. The TB prevalence among all participants and among those with presumptive TB were respectively 1.2% and 8.6%. The number needed to screen was 84. Among people with presumptive TB, the proportion of males and females with confirmed TB was respectively 12.0% and 5.6% (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>TB screening using DLB X-ray during community-based ACF in hard-to-reach Niger Delta communities of Nigeria showed a high TB prevalence among participants. Nationwide deployment of the instrument in hard-to-reach areas is recommended.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176193/pdf/i2220-8372-12-2-85.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
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