Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review.
Community-based active case-finding (ACF) may have important impacts on routine TB case-detection and subsequent patient-initiated diagnosis pathways, contributing "indirectly" to infectious diseases prevention and care. We investigated the impact of ACF beyond directly diagnosed patients...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0000088 |
| _version_ | 1797694180173021184 |
|---|---|
| author | Helena R A Feasey Rachael M Burke Marriott Nliwasa Lelia H Chaisson Jonathan E Golub Fahd Naufal Adrienne E Shapiro Maria Ruperez Lily Telisinghe Helen Ayles Cecily Miller Helen E D Burchett Peter MacPherson Elizabeth L Corbett |
| author_facet | Helena R A Feasey Rachael M Burke Marriott Nliwasa Lelia H Chaisson Jonathan E Golub Fahd Naufal Adrienne E Shapiro Maria Ruperez Lily Telisinghe Helen Ayles Cecily Miller Helen E D Burchett Peter MacPherson Elizabeth L Corbett |
| author_sort | Helena R A Feasey |
| collection | DOAJ |
| description | Community-based active case-finding (ACF) may have important impacts on routine TB case-detection and subsequent patient-initiated diagnosis pathways, contributing "indirectly" to infectious diseases prevention and care. We investigated the impact of ACF beyond directly diagnosed patients for TB, using routine case-notification rate (CNR) ratios as a measure of indirect effect. We systematically searched for publications 01-Jan-1980 to 13-Apr-2020 reporting on community-based ACF interventions compared to a comparison group, together with review of linked manuscripts reporting knowledge, attitudes, and practices (KAP) outcomes or qualitative data on TB testing behaviour. We calculated CNR ratios of routine case-notifications (i.e. excluding cases identified directly through ACF) and compared proxy behavioural outcomes for both ACF and comparator communities. Full text manuscripts from 988 of 23,883 abstracts were screened for inclusion; 36 were eligible. Of these, 12 reported routine notification rates separately from ACF intervention-attributed rates, and one reported any proxy behavioural outcomes. Two further studies were identified from screening 1121 abstracts for linked KAP/qualitative manuscripts. 8/12 case-notification studies were considered at critical or serious risk of bias. 8/11 non-randomised studies reported bacteriologically-confirmed CNR ratios between 0.47 (95% CI:0.41-0.53) and 0.96 (95% CI:0.94-0.97), with 7/11 reporting all-form CNR ratios between 0.96 (95% CI:0.88-1.05) and 1.09 (95% CI:1.02-1.16). One high-quality randomised-controlled trial reported a ratio of 1.14 (95% CI 0.91-1.43). KAP/qualitative manuscripts provided insufficient evidence to establish the impact of ACF on subsequent TB testing behaviour. ACF interventions with routine CNR ratios >1 suggest an indirect effect on wider TB case-detection, potentially due to impact on subsequent TB testing behaviour through follow-up after a negative ACF test or increased TB knowledge. However, data on this type of impact are rarely collected. Evaluation of routine case-notification, testing and proxy behavioural outcomes in intervention and comparator communities should be included as standard methodology in future ACF campaign study designs. |
| first_indexed | 2024-03-12T02:54:11Z |
| format | Article |
| id | doaj.art-69853c1d5eb94dbeb59c2c5e09f2717b |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T02:54:11Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-69853c1d5eb94dbeb59c2c5e09f2717b2023-09-03T15:25:43ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752021-01-01112e000008810.1371/journal.pgph.0000088Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review.Helena R A FeaseyRachael M BurkeMarriott NliwasaLelia H ChaissonJonathan E GolubFahd NaufalAdrienne E ShapiroMaria RuperezLily TelisingheHelen AylesCecily MillerHelen E D BurchettPeter MacPhersonElizabeth L CorbettCommunity-based active case-finding (ACF) may have important impacts on routine TB case-detection and subsequent patient-initiated diagnosis pathways, contributing "indirectly" to infectious diseases prevention and care. We investigated the impact of ACF beyond directly diagnosed patients for TB, using routine case-notification rate (CNR) ratios as a measure of indirect effect. We systematically searched for publications 01-Jan-1980 to 13-Apr-2020 reporting on community-based ACF interventions compared to a comparison group, together with review of linked manuscripts reporting knowledge, attitudes, and practices (KAP) outcomes or qualitative data on TB testing behaviour. We calculated CNR ratios of routine case-notifications (i.e. excluding cases identified directly through ACF) and compared proxy behavioural outcomes for both ACF and comparator communities. Full text manuscripts from 988 of 23,883 abstracts were screened for inclusion; 36 were eligible. Of these, 12 reported routine notification rates separately from ACF intervention-attributed rates, and one reported any proxy behavioural outcomes. Two further studies were identified from screening 1121 abstracts for linked KAP/qualitative manuscripts. 8/12 case-notification studies were considered at critical or serious risk of bias. 8/11 non-randomised studies reported bacteriologically-confirmed CNR ratios between 0.47 (95% CI:0.41-0.53) and 0.96 (95% CI:0.94-0.97), with 7/11 reporting all-form CNR ratios between 0.96 (95% CI:0.88-1.05) and 1.09 (95% CI:1.02-1.16). One high-quality randomised-controlled trial reported a ratio of 1.14 (95% CI 0.91-1.43). KAP/qualitative manuscripts provided insufficient evidence to establish the impact of ACF on subsequent TB testing behaviour. ACF interventions with routine CNR ratios >1 suggest an indirect effect on wider TB case-detection, potentially due to impact on subsequent TB testing behaviour through follow-up after a negative ACF test or increased TB knowledge. However, data on this type of impact are rarely collected. Evaluation of routine case-notification, testing and proxy behavioural outcomes in intervention and comparator communities should be included as standard methodology in future ACF campaign study designs.https://doi.org/10.1371/journal.pgph.0000088 |
| spellingShingle | Helena R A Feasey Rachael M Burke Marriott Nliwasa Lelia H Chaisson Jonathan E Golub Fahd Naufal Adrienne E Shapiro Maria Ruperez Lily Telisinghe Helen Ayles Cecily Miller Helen E D Burchett Peter MacPherson Elizabeth L Corbett Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review. PLOS Global Public Health |
| title | Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review. |
| title_full | Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review. |
| title_fullStr | Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review. |
| title_full_unstemmed | Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review. |
| title_short | Do community-based active case-finding interventions have indirect impacts on wider TB case detection and determinants of subsequent TB testing behaviour? A systematic review. |
| title_sort | do community based active case finding interventions have indirect impacts on wider tb case detection and determinants of subsequent tb testing behaviour a systematic review |
| url | https://doi.org/10.1371/journal.pgph.0000088 |
| work_keys_str_mv | AT helenarafeasey docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT rachaelmburke docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT marriottnliwasa docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT leliahchaisson docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT jonathanegolub docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT fahdnaufal docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT adrienneeshapiro docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT mariaruperez docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT lilytelisinghe docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT helenayles docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT cecilymiller docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT helenedburchett docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT petermacpherson docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview AT elizabethlcorbett docommunitybasedactivecasefindinginterventionshaveindirectimpactsonwidertbcasedetectionanddeterminantsofsubsequenttbtestingbehaviourasystematicreview |