A P Babayi, B B Odume, C L Ogbudebe, O Chukwuogo, N Nwokoye, C C Dim, S Useni, D Nongo, R Eneogu, O Chijioke-Akaniro, C Anyaike
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Improving TB control: efficiencies of case-finding interventions in Nigeria.
Setting: KNCV Nigeria implements seven key TB case-finding interventions. It was critical to evaluate the efficiency of these interventions in terms of TB yield to direct future prioritisation in the country.
Objectives: To compare the efficiency of active case-finding (ACF) interventions for TB in Nigeria.
Design: Data from the 2020-2022 implementing period were analysed retrospectively. Intervention efficiencies were analysed using the number needed to screen (NNS), the number needed to test (NNT) and the true screen-positive (TSP) rate.
Results: Across the interventions, 21,704,669 persons were screened for TB, 1,834,447 (8.5%) were presumed to have TB (7.7% pre-diagnostic drop-out rate) and 122,452 were diagnosed with TB (TSP rate of 7.2%). The average TSP rate of interventions that used both the WHO four-symptom screen (W4SS) and portable digital X-ray (PDX) screening algorithm was significantly higher (22.6%) than those that employed the former alone (7.0%; OR 3.9, 95% CI 3.74-3.98; P < 0.001). The average NNT for interventions with W4SS/PDX screening was 4 (range: 4-5), while that of W4SS-only screening was 14 (range: 11-22).
Conclusions: Interventions using the PDX in addition to W4SS for TB screening were more efficient in terms of TB case yield than interventions that used symptom-based TB screening only.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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