Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study
This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of soci...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/6/2/50 |
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| author | Suman Chandra Gurung Kritika Dixit Bhola Rai Raghu Dhital Puskar Raj Paudel Shraddha Acharya Gangaram Budhathoki Deepak Malla Jens W. Levy Knut Lönnroth Andrew Ramsay Buddha Basnyat Anil Thapa Gokul Mishra Bishal Subedi Mohammad Kashim Shah Anil Shrestha Maxine Caws |
| author_facet | Suman Chandra Gurung Kritika Dixit Bhola Rai Raghu Dhital Puskar Raj Paudel Shraddha Acharya Gangaram Budhathoki Deepak Malla Jens W. Levy Knut Lönnroth Andrew Ramsay Buddha Basnyat Anil Thapa Gokul Mishra Bishal Subedi Mohammad Kashim Shah Anil Shrestha Maxine Caws |
| author_sort | Suman Chandra Gurung |
| collection | DOAJ |
| description | This study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092; 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4; 95%CI = 1.12–1.72; p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally. |
| first_indexed | 2024-03-10T12:19:37Z |
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| id | doaj.art-a9f10e83b06f43ddb33dce56d6074d34 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-10T12:19:37Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-a9f10e83b06f43ddb33dce56d6074d342023-11-21T15:35:12ZengMDPI AGTropical Medicine and Infectious Disease2414-63662021-04-01625010.3390/tropicalmed6020050Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional StudySuman Chandra Gurung0Kritika Dixit1Bhola Rai2Raghu Dhital3Puskar Raj Paudel4Shraddha Acharya5Gangaram Budhathoki6Deepak Malla7Jens W. Levy8Knut Lönnroth9Andrew Ramsay10Buddha Basnyat11Anil Thapa12Gokul Mishra13Bishal Subedi14Mohammad Kashim Shah15Anil Shrestha16Maxine Caws17Birat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalKNCV Tuberculosis Foundation, 2514 JD The Hague, The NetherlandsDepartment of Global Public Health, WHO Collaborating Center on Tuberculosis and Social Medicine, Karolinska Institutet, 10653 Stockholm, SwedenSchool of Medicine, University of St Andrews, St Andrews KY16 9TF, UKOxford University Clinical Research Unit, Kathmandu 44600, NepalNational Tuberculosis Centre, Kathmandu 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalHealth Office, Pyuthan 22300, NepalNick Simons Institute, Lalitpur 44600, NepalNick Simons Institute, Lalitpur 44600, NepalBirat Nepal Medical Trust, Kathmandu 44600, NepalThis study compared the yield of tuberculosis (TB) active case finding (ACF) interventions applied under TB REACH funding. Between June 2017 to November 2018, Birat Nepal Medical Trust identified presumptive cases using simple verbal screening from three interventions: door-to-door screening of social contacts of known index cases, TB camps in remote areas, and screening for hospital out-patient department (OPD) attendees. Symptomatic individuals were then tested using smear microscopy or GeneXpert MTB/RIF as first diagnostic test. Yield rates were compared for each intervention and diagnostic method. We evaluated additional cases notified from ACF interventions by comparing case notifications of the intervention and control districts using standard TB REACH methodology. The project identified 1092 TB cases. The highest yield was obtained from OPD screening at hospitals (n = 566/1092; 52%). The proportion of positive tests using GeneXpert (5.5%, n = 859/15,637) was significantly higher than from microscopy testing 2% (n = 120/6309). (OR = 1.4; 95%CI = 1.12–1.72; p = 0.0026). The project achieved 29% additionality in case notifications in the intervention districts demonstrating that GeneXpert achieved substantially higher case-finding yields. Therefore, to increase national case notification for TB, Nepal should integrate OPD screening using GeneXpert testing in every district hospital and scale up of community-based ACF of TB patient contacts nationally.https://www.mdpi.com/2414-6366/6/2/50active case findingTB yield rateACF strategiesACF interventionsGeneXpertNepal |
| spellingShingle | Suman Chandra Gurung Kritika Dixit Bhola Rai Raghu Dhital Puskar Raj Paudel Shraddha Acharya Gangaram Budhathoki Deepak Malla Jens W. Levy Knut Lönnroth Andrew Ramsay Buddha Basnyat Anil Thapa Gokul Mishra Bishal Subedi Mohammad Kashim Shah Anil Shrestha Maxine Caws Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study Tropical Medicine and Infectious Disease active case finding TB yield rate ACF strategies ACF interventions GeneXpert Nepal |
| title | Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study |
| title_full | Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study |
| title_fullStr | Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study |
| title_full_unstemmed | Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study |
| title_short | Comparative Yield of Tuberculosis during Active Case Finding Using GeneXpert or Smear Microscopy for Diagnostic Testing in Nepal: A Cross-Sectional Study |
| title_sort | comparative yield of tuberculosis during active case finding using genexpert or smear microscopy for diagnostic testing in nepal a cross sectional study |
| topic | active case finding TB yield rate ACF strategies ACF interventions GeneXpert Nepal |
| url | https://www.mdpi.com/2414-6366/6/2/50 |
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