Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0441
K. Viney, A. Baddeley, E. Jaramillo, M. Calvi, A. Carlqvist, F. Mavhunga
{"title":"Assessing for comorbidities, determinants and disability during TB treatment","authors":"K. Viney, A. Baddeley, E. Jaramillo, M. Calvi, A. Carlqvist, F. Mavhunga","doi":"10.5588/ijtldopen.23.0441","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0441","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0376
S. M. A. Zaidi, W. Z. Jamal, U. Ibrahim, S. Khowaja, A. J. Khan, J. Creswell
BACKGROUNDExisting models to increase TB case notifications from the private sector in Pakistan are financially unsustainable and have achieved modest success due to limited coverage.OBJECTIVETo evaluate the impact of a social enterprise model (SEM) intervention on TB case detection in Karachi, Pakistan, and to assess its financial sustainability.METHODSPurpose-built centres were established within the private sector that integrated TB screening, diagnostics and treatment and operated 12 hours per day with convenient locations to improve access. TB services were offered free of cost, and revenue generation took place through user fees from other diagnostics. Private providers with a focus on the informal sector were engaged through community workers to generate screening referrals.RESULTSOverall 171,488 people were screened and 18,683 cases were notified, including 197 individuals with drug-resistant TB. Annual TB notifications in Karachi increased from 18,105 in 2014 to a maximum of 25,840 (40% increase). The proportion of cases in Karachi notified by the centres grew to 27% in 2020. Commercial revenue reached USD288,065 and enabled operating cost recovery of 15%. Average cost per TB case notified was USD203.CONCLUSIONThe SEM intervention contributed a large proportion of notifications in Karachi and achieved modest cost recovery.
{"title":"A social enterprise model for TB detection and treatment through the private sector in Pakistan","authors":"S. M. A. Zaidi, W. Z. Jamal, U. Ibrahim, S. Khowaja, A. J. Khan, J. Creswell","doi":"10.5588/ijtldopen.23.0376","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0376","url":null,"abstract":"BACKGROUNDExisting models to increase TB case notifications from the private sector in Pakistan are financially unsustainable and have achieved modest success due to limited coverage.OBJECTIVETo\u0000 evaluate the impact of a social enterprise model (SEM) intervention on TB case detection in Karachi, Pakistan, and to assess its financial sustainability.METHODSPurpose-built centres were established within the private sector that integrated\u0000 TB screening, diagnostics and treatment and operated 12 hours per day with convenient locations to improve access. TB services were offered free of cost, and revenue generation took place through user fees from other diagnostics. Private providers with a focus on the informal sector were engaged\u0000 through community workers to generate screening referrals.RESULTSOverall 171,488 people were screened and 18,683 cases were notified, including 197 individuals with drug-resistant TB. Annual TB notifications in Karachi increased from 18,105\u0000 in 2014 to a maximum of 25,840 (40% increase). The proportion of cases in Karachi notified by the centres grew to 27% in 2020. Commercial revenue reached USD288,065 and enabled operating cost recovery of 15%. Average cost per TB case notified was USD203.CONCLUSIONThe\u0000 SEM intervention contributed a large proportion of notifications in Karachi and achieved modest cost recovery.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0484
B. F. Melingui, E. Leroy-Terquem, M. Palmer, J-V. Taguebue, A. P. Wachinou, J. Gaudelus, A. Salomao, D. Bunnet, T. C. Eap, L. Borand, C. Chabala, C. Khosa, R. Moh, J. Mwanga-Amumpere, M. T. Eang, I. Manhiça, A. Mustapha, S. Beneteau, L. Falzon, J. Seddon, L. Berteloot, E. Wobudeya, O. Marcy, M. Bonnet, P. Y. Norval
BACKGROUNDChest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries.METHODSWithin the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features. We performed a pre–post training assessment on a pre-defined set of 20 CXR readings. We compared the proportion of correctly interpreted CXRs and the median reading score before and after the training using the McNemar test and a linear mixed model.RESULTSOf 191 HCWs, 43 (23%) were physicians, 103 (54%) nurses, 18 (9.4%) radiology technicians and 12 (6.3%) other professionals. Of 2,840 CXRs with both assessment, respectively 1,843 (64.9%) and 2,277 (80.2%) were correctly interpreted during pre-training and post-training (P < 0.001). The median reading score improved significantly from 13/20 to 16/20 after the training, after adjusting by country, facility and profession (adjusted β = 3.31, 95% CI 2.44–4.47).CONCLUSIONDespite some limitations of the course assessment that did not include abnormal non-TB suggestive CXR, study findings suggest that a short CXR training course could improve HCWs’ interpretation skills in diagnosing paediatric TB.
{"title":"Evaluation of a short training course of chest X-ray interpretation for the diagnosis of paediatric TB","authors":"B. F. Melingui, E. Leroy-Terquem, M. Palmer, J-V. Taguebue, A. P. Wachinou, J. Gaudelus, A. Salomao, D. Bunnet, T. C. Eap, L. Borand, C. Chabala, C. Khosa, R. Moh, J. Mwanga-Amumpere, M. T. Eang, I. Manhiça, A. Mustapha, S. Beneteau, L. Falzon, J. Seddon, L. Berteloot, E. Wobudeya, O. Marcy, M. Bonnet, P. Y. Norval","doi":"10.5588/ijtldopen.23.0484","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0484","url":null,"abstract":"BACKGROUNDChest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence\u0000 countries.METHODSWithin the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features. We performed a pre–post training assessment\u0000 on a pre-defined set of 20 CXR readings. We compared the proportion of correctly interpreted CXRs and the median reading score before and after the training using the McNemar test and a linear mixed model.RESULTSOf 191 HCWs, 43 (23%) were\u0000 physicians, 103 (54%) nurses, 18 (9.4%) radiology technicians and 12 (6.3%) other professionals. Of 2,840 CXRs with both assessment, respectively 1,843 (64.9%) and 2,277 (80.2%) were correctly interpreted during pre-training and post-training (P < 0.001). The median reading score\u0000 improved significantly from 13/20 to 16/20 after the training, after adjusting by country, facility and profession (adjusted β = 3.31, 95% CI 2.44–4.47).CONCLUSIONDespite some limitations of the course assessment that did not\u0000 include abnormal non-TB suggestive CXR, study findings suggest that a short CXR training course could improve HCWs’ interpretation skills in diagnosing paediatric TB.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0397
P. Mbelele, F. J. Mtei, F. Thobias, K. S. Msaji, L. Løchting, L. M. Subi, D. Bwana, R. M. Kisonga, P. Neema, P. Howlett, M. Drage, S. Heysell, S. G. Mpagama
{"title":"A call to invest in post-TB lung disease to halt TB transmission in communities","authors":"P. Mbelele, F. J. Mtei, F. Thobias, K. S. Msaji, L. Løchting, L. M. Subi, D. Bwana, R. M. Kisonga, P. Neema, P. Howlett, M. Drage, S. Heysell, S. G. Mpagama","doi":"10.5588/ijtldopen.23.0397","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0397","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0462
D. Wademan, H. R. Draper, S. Purchase, M. Palmer, A. Hesseling, L. E. van der Laan, A. Garcia-Prats
BACKGROUNDWe evaluated the palatability and acceptability of a 100 mg dispersible and a non-dispersible 250 mg levofloxacin (LVX) tablet formulation in children.METHODSPerform was a randomised, open-label, cross-over trial of the relative bioavailability of LVX dispersible vs. crushed non-dispersible tablets in children aged <6 years routinely receiving TB preventive treatment. Children and caregivers completed Likert- and ranking-type measures on the acceptability of both formulations. We used summary, comparative and ranking statistics to characterise formulation acceptability.RESULTSA total of 25 children were enrolled (median age: 2.6 years, IQR 1.6–4.0). Caregivers reported frequent challenges with preventive therapy in routine care prior to study entry, including taste of tablets (n = 14, 56%), vomiting/spitting out medicines (n = 11, 44%), and children refusing medicines (n = 10, 40%). Caregivers reported that the dispersible formulation was easier for their child to take than the non-dispersible formulation (P = 0.0253). Mean ranks for caregiver’s formulation preferences (dispersible tablets: 1.48, SD ±0.71; non-dispersible tablets: 2.12, SD ±0.67; routinely available formulations: 2.40 SD ±0.82) differed significantly (Friedman’s F 11.120; P < 0.0038); post-hoc testing showed dispersible tablets were preferred over non-dispersible (P = 0.018) and routinely available LVX formulations (P < 0.001).CONCLUSIONSThe dispersible LVX 100 mg tablet formulation was preferred and should be prioritised for integration into routine care.
{"title":"Acceptability of levofloxacin dispersible and non-dispersible tablet formulations in children receiving TB preventive treatment","authors":"D. Wademan, H. R. Draper, S. Purchase, M. Palmer, A. Hesseling, L. E. van der Laan, A. Garcia-Prats","doi":"10.5588/ijtldopen.23.0462","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0462","url":null,"abstract":"BACKGROUNDWe evaluated the palatability and acceptability of a 100 mg dispersible and a non-dispersible 250 mg levofloxacin (LVX) tablet formulation in children.METHODSPerform was a randomised,\u0000 open-label, cross-over trial of the relative bioavailability of LVX dispersible vs. crushed non-dispersible tablets in children aged <6 years routinely receiving TB preventive treatment. Children and caregivers completed Likert- and ranking-type measures on the acceptability of both formulations.\u0000 We used summary, comparative and ranking statistics to characterise formulation acceptability.RESULTSA total of 25 children were enrolled (median age: 2.6 years, IQR 1.6–4.0). Caregivers reported frequent challenges with preventive\u0000 therapy in routine care prior to study entry, including taste of tablets (n = 14, 56%), vomiting/spitting out medicines (n = 11, 44%), and children refusing medicines (n = 10, 40%). Caregivers reported that the dispersible formulation was easier for their child to take\u0000 than the non-dispersible formulation (P = 0.0253). Mean ranks for caregiver’s formulation preferences (dispersible tablets: 1.48, SD ±0.71; non-dispersible tablets: 2.12, SD ±0.67; routinely available formulations: 2.40 SD ±0.82) differed significantly (Friedman’s\u0000 F 11.120; P < 0.0038); post-hoc testing showed dispersible tablets were preferred over non-dispersible (P = 0.018) and routinely available LVX formulations (P < 0.001).CONCLUSIONSThe dispersible LVX 100\u0000 mg tablet formulation was preferred and should be prioritised for integration into routine care.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139965832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0283
A. Musinguzi, H. E. Aschmann, J. Kadota, J. Nakimuli, F. Welishe, J. Kakeeto, C. Namale, L. Akello, A. Nakitende, C. Berger, A. Katamba, J. Tumuhamye, N. Kiwanuka, D. Dowdy, A. Cattamanchi, F. Semitala
BACKGROUNDBoth 1 month of daily (1HP) and 3 months of weekly (3HP) isoniazid-rifapentine are recommended as short-course regimens for TB prevention among people living with HIV (PLHIV). We aimed to assess acceptability and preferences for 1HP vs. 3HP among PLHIV.METHODSIn a cross-sectional survey among PLHIV at an HIV clinic in Kampala, Uganda, participants were randomly assigned to a hypothetical scenario of receiving 1HP or 3HP. Participants rated their level of perceived intention and confidence to complete treatment using a 0–10 Likert scale, and chose between 1HP and 3HP.RESULTSAmong 429 respondents (median age: 43 years, 71% female, median time on ART: 10 years), intention and confidence were rated high for both regimens. Intention to complete treatment was rated at least 7/10 by 92% (189/206 randomized to 1HP) and 93% (207/223 randomized to 3HP). Respectively 86% (178/206) and 93% (208/223) expressed high confidence to complete treatment. Overall, 81% (348/429) preferred 3HP over 1HP.CONCLUSIONSBoth 1HP and 3HP were highly acceptable regimens, with 3HP preferred by most PLHIV. Weekly, rather than daily, dosing appears preferable to shorter duration of treatment, which should inform scale-up and further development of short-course regimens for TB prevention.
{"title":"Preference for daily (1HP) vs. weekly (3HP) isoniazid-rifapentine among people living with HIV in Uganda","authors":"A. Musinguzi, H. E. Aschmann, J. Kadota, J. Nakimuli, F. Welishe, J. Kakeeto, C. Namale, L. Akello, A. Nakitende, C. Berger, A. Katamba, J. Tumuhamye, N. Kiwanuka, D. Dowdy, A. Cattamanchi, F. Semitala","doi":"10.5588/ijtldopen.23.0283","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0283","url":null,"abstract":"BACKGROUNDBoth 1 month of daily (1HP) and 3 months of weekly (3HP) isoniazid-rifapentine are recommended as short-course regimens for TB prevention among people living with HIV (PLHIV). We aimed to assess acceptability and preferences for 1HP\u0000 vs. 3HP among PLHIV.METHODSIn a cross-sectional survey among PLHIV at an HIV clinic in Kampala, Uganda, participants were randomly assigned to a hypothetical scenario of receiving 1HP or 3HP. Participants rated their level of perceived\u0000 intention and confidence to complete treatment using a 0–10 Likert scale, and chose between 1HP and 3HP.RESULTSAmong 429 respondents (median age: 43 years, 71% female, median time on ART: 10 years), intention and confidence were rated\u0000 high for both regimens. Intention to complete treatment was rated at least 7/10 by 92% (189/206 randomized to 1HP) and 93% (207/223 randomized to 3HP). Respectively 86% (178/206) and 93% (208/223) expressed high confidence to complete treatment. Overall, 81% (348/429) preferred 3HP over 1HP.CONCLUSIONSBoth\u0000 1HP and 3HP were highly acceptable regimens, with 3HP preferred by most PLHIV. Weekly, rather than daily, dosing appears preferable to shorter duration of treatment, which should inform scale-up and further development of short-course regimens for TB prevention.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.5588/ijtldopen.23.0615
A. Harries, D. Nair, P. Thekkur, R. Ananthakrishnan, R. Thiagesan, J. M. Chakaya, I. Mbithi, B. Jamil, R. Fatima, M. Khogali, R. Zachariah, S. Berger, S. Satyanarayana, A. M. V. Kumar, A. Bochner, A. McClelland
{"title":"Applying ‘timeliness’ to the screening and prevention of TB in household contacts of pulmonary TB patients","authors":"A. Harries, D. Nair, P. Thekkur, R. Ananthakrishnan, R. Thiagesan, J. M. Chakaya, I. Mbithi, B. Jamil, R. Fatima, M. Khogali, R. Zachariah, S. Berger, S. Satyanarayana, A. M. V. Kumar, A. Bochner, A. McClelland","doi":"10.5588/ijtldopen.23.0615","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0615","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.5588/ijtldopen.23.0194
L. Gunde, A. Wang, D. Payne, S. O'Connor, A. Kabaghe, N. Kalata, A. Maida, D. Kayira, V. Buie, L. Tauzi, A. Sankhani, A. Thawani, E. Rambik, A. Ahimbisibwe, T. Maphosa, K. Kudiabor, R. Nyirenda, J. Mpunga, K. Mbendera, P. Nyasulu, F. Kayigamba, M. Farahani, A.C. Voetsch, K. Brown, A. Jahn, B. Girma, K. Mirkovic, MPHIA Survey Team
BACKGROUND: TB preventive treatment (TPT) reduces morbidity and mortality among people living with HIV (PLHIV). Despite the successful scale-up of TPT in Malawi, monitoring and evaluation have been suboptimal. We utilized the Malawi Population-Based HIV Impact Assessment (MPHIA) 2020‐2021 survey data to estimate TPT uptake and completion among self-reported HIVpositive persons.METHODS: We estimated the proportion of HIV-positive respondents who had ever undergone TPT, and determined the percentage of those currently on TPT who had completed more than 6 months of treatment. Bivariate and multivariable logistic regression were performed to calculate the odds ratios for factors associated with evertaking TPT. All variables were self-reported, and the analysis was weighted and accounted for in the survey design.RESULTS: Of the HIV+ respondents, 38.8% (95% CI 36.4‐41.3) had ever taken TPT. The adjusted odds of ever taking TPT were 8.0 and 5.2 times as high in the Central and Southern regions, respectively, compared to the Northern region; 1.9 times higher among those in the highest wealth quintile, and 2.1 times higher for those on antiretroviral therapy >10 years. Of those currently taking TPT, 56.2% completed >6 months of TPT.CONCLUSION: These results suggest low TPT uptake and >6 months’ completion rates among self-reported HIV+ persons. Initiatives to create demand and strengthen adherence would improve TPT uptake.
背景：结核病预防性治疗（TPT）可降低艾滋病毒感染者（PLHIV）的发病率和死亡率。尽管结核病预防治疗在马拉维成功推广，但监测和评估工作一直不尽如人意。我们利用马拉维 2020-2021 年基于人口的艾滋病影响评估（MPHIA）调查数据，估算了自我报告的 HIV 阳性者中 TPT 的接受率和完成率。方法：我们估算了曾经接受过 TPT 的 HIV 阳性受访者的比例，并确定了目前正在接受 TPT 且已完成 6 个月以上治疗的受访者的比例。我们进行了二元和多元逻辑回归，以计算与曾经接受 TPT 相关因素的几率比。所有变量均由受访者自我报告，调查设计中对分析结果进行了加权和计算。结果：在 HIV 感染者中，38.8%（95% CI 36.4-41.3）的受访者曾经服用过 TPT。与北部地区相比，中部地区和南部地区曾经服用 TPT 的调整后几率分别是北部地区的 8.0 倍和 5.2 倍；在财富最高的五分之一人口中，曾经服用 TPT 的几率是北部地区的 1.9 倍；在接受抗逆转录病毒治疗超过 10 年的人口中，曾经服用 TPT 的几率是北部地区的 2.1 倍。结论：这些结果表明，在自我报告的 HIV 感染者中，TPT 的接受率和超过 6 个月的完成率都很低。为创造需求和加强依从性而采取的措施将提高 TPT 的服用率。
{"title":"Characteristics of TPT initiation and completion among people living with HIV","authors":"L. Gunde, A. Wang, D. Payne, S. O'Connor, A. Kabaghe, N. Kalata, A. Maida, D. Kayira, V. Buie, L. Tauzi, A. Sankhani, A. Thawani, E. Rambik, A. Ahimbisibwe, T. Maphosa, K. Kudiabor, R. Nyirenda, J. Mpunga, K. Mbendera, P. Nyasulu, F. Kayigamba, M. Farahani, A.C. Voetsch, K. Brown, A. Jahn, B. Girma, K. Mirkovic, MPHIA Survey Team","doi":"10.5588/ijtldopen.23.0194","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0194","url":null,"abstract":"BACKGROUND: TB preventive treatment (TPT) reduces morbidity and mortality among people living with HIV (PLHIV). Despite the successful scale-up of TPT in Malawi, monitoring and evaluation have been suboptimal. We utilized the Malawi Population-Based HIV Impact Assessment (MPHIA) 2020‐2021\u0000 survey data to estimate TPT uptake and completion among self-reported HIVpositive persons.METHODS: We estimated the proportion of HIV-positive respondents who had ever undergone TPT, and determined the percentage of those currently on TPT who had completed more than 6 months of treatment.\u0000 Bivariate and multivariable logistic regression were performed to calculate the odds ratios for factors associated with evertaking TPT. All variables were self-reported, and the analysis was weighted and accounted for in the survey design.RESULTS: Of the HIV+ respondents, 38.8%\u0000 (95% CI 36.4‐41.3) had ever taken TPT. The adjusted odds of ever taking TPT were 8.0 and 5.2 times as high in the Central and Southern regions, respectively, compared to the Northern region; 1.9 times higher among those in the highest wealth quintile, and 2.1 times higher for those\u0000 on antiretroviral therapy >10 years. Of those currently taking TPT, 56.2% completed >6 months of TPT.CONCLUSION: These results suggest low TPT uptake and >6 months’ completion rates among self-reported HIV+ persons. Initiatives to create demand and strengthen\u0000 adherence would improve TPT uptake.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.5588/ijtldopen.23.0576
G. B. Migliori, V. Bhatia, L. D'Ambrosio, M.C.B. Raviglione, S. Rijal
{"title":"More is needed to end TB: commentary on the United Nations High-Level Meeting on TB","authors":"G. B. Migliori, V. Bhatia, L. D'Ambrosio, M.C.B. Raviglione, S. Rijal","doi":"10.5588/ijtldopen.23.0576","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0576","url":null,"abstract":"","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140522396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SETTING: Côte d'Ivoire is a country with a high incidence of TB. The control of TB infection is focused on high-risk patients but has limited implementation.OBJECTIVE: Cost-benefit analysis of TB infection (TBI) screening of household contacts in Côte d'Ivoire to evaluate economic implications of the implementation of interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST).DESIGN: We compared the effectiveness of QuantiFERON-TB Gold Plus (QuantiFERON) with the TST using an economic model previously evaluated in medium TB incidence settings. Principal outcomes relating to TBI screening, as well as the lifetime costs and benefits of the patient cohort, were captured using a decision tree, followed by a Markov model.RESULTS: QuantiFERON proved to be both more effective and less costly than TST. Compared to QuantiFERON, TST use leads to an approximate 33% increase in the lifetime risk of developing active TB.CONCLUSIONS: For household contacts of active TB cases in Côte d'Ivoire, QuantiFERON is cost-effective when compared with TST. R shiny interactive interface enables model customisation for different scenarios, settings, risk groups and TBI screening methods. Further research should be conducted in similar settings to generalise the results.
{"title":"Screening of household contacts for TB infection in Cote d'Ivoire","authors":"R.K. N’Guessan, D.A.B. Orsot, J. Ahui Brou, N.K. Bamba, M.E. Tchoutedjem Mefo, A.S. Bakayoko","doi":"10.5588/ijtldopen.23.0342","DOIUrl":"https://doi.org/10.5588/ijtldopen.23.0342","url":null,"abstract":"SETTING: Côte d'Ivoire is a country with a high incidence of TB. The control of TB infection is focused on high-risk patients but has limited implementation.OBJECTIVE: Cost-benefit analysis of TB infection (TBI) screening of household contacts in Côte d'Ivoire to evaluate\u0000 economic implications of the implementation of interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST).DESIGN: We compared the effectiveness of QuantiFERON-TB Gold Plus (QuantiFERON) with the TST using an economic model previously evaluated in medium TB incidence settings.\u0000 Principal outcomes relating to TBI screening, as well as the lifetime costs and benefits of the patient cohort, were captured using a decision tree, followed by a Markov model.RESULTS: QuantiFERON proved to be both more effective and less costly than TST. Compared to QuantiFERON, TST use\u0000 leads to an approximate 33% increase in the lifetime risk of developing active TB.CONCLUSIONS: For household contacts of active TB cases in Côte d'Ivoire, QuantiFERON is cost-effective when compared with TST. R shiny interactive interface enables model customisation for different\u0000 scenarios, settings, risk groups and TBI screening methods. Further research should be conducted in similar settings to generalise the results.","PeriodicalId":516613,"journal":{"name":"IJTLD OPEN","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140526516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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