Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes?
Background: Pakistan implemented initiatives to detect tuberculosis (TB) patients through extended contact screening (ECS); it improved case detection but treatment outcomes need assessment. Objectives: To compare treatment outcomes of pulmonary TB (PTB) patients detected by ECS with those detected...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221000655 |
| _version_ | 1829490149281497088 |
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| author | Mahboob Ul Haq Sven G. Hinderaker Razia Fatima Hemant Deepak Shewade Einar Heldal Abdullah Latif Ajay M.V. Kumar |
| author_facet | Mahboob Ul Haq Sven G. Hinderaker Razia Fatima Hemant Deepak Shewade Einar Heldal Abdullah Latif Ajay M.V. Kumar |
| author_sort | Mahboob Ul Haq |
| collection | DOAJ |
| description | Background: Pakistan implemented initiatives to detect tuberculosis (TB) patients through extended contact screening (ECS); it improved case detection but treatment outcomes need assessment. Objectives: To compare treatment outcomes of pulmonary TB (PTB) patients detected by ECS with those detected by routine passive case finding (PCF). Methods: A cohort study using secondary program data conducted in Lahore, Faisalabad and Rawalpindi districts and Islamabad in 2013–15. We used log binomial regression models to assess if ECS was associated with unfavorable treatment outcomes (death, loss-to-follow-up, failure, not evaluated) after adjusting for potential confounders. Results: We included 79,431 people with PTB; 4604 (5.8%) were detected by ECS with 4052 (88%) bacteriologically confirmed. In all PTB patients the proportion with unfavorable outcomes was not significantly different in ECS group (9.6%) compared to PCF (9.9%), however, among bacteriologically confirmed patients unfavorable outcomes were significantly lower in ECS (9.9%) than PCF group (11.6%, P = 0.001). ECS was associated with a lower risk of unfavorable outcomes (adjusted relative risk (aRR) 0.90; 95% CI 0.82–0.99) among ‘all PTB’ patients and bacteriologically confirmed PTB patients (aRR 0.91; 95% CI 0.82–1.00). Conclusion: In PTB patients detected by ECS the treatment outcomes were not inferior to those detected by PCF. |
| first_indexed | 2024-12-15T00:19:36Z |
| format | Article |
| id | doaj.art-e156142494b34f8b98fd7c014d4225bf |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-15T00:19:36Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-e156142494b34f8b98fd7c014d4225bf2022-12-21T22:42:21ZengElsevierInternational Journal of Infectious Diseases1201-97122021-03-01104634640Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes?Mahboob Ul Haq0Sven G. Hinderaker1Razia Fatima2Hemant Deepak Shewade3Einar Heldal4Abdullah Latif5Ajay M.V. Kumar6University of Bergen, Norway; Common Management Unit (HIV/AIDS, TB & Malaria), Islamabad, Pakistan; Corresponding author at: Department of Global Public Health and Primary Care, University of Bergen, Norway.University of Bergen, NorwayCommon Management Unit (HIV/AIDS, TB & Malaria), Islamabad, PakistanCentre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; The Union South-East Asia Office, New Delhi, IndiaNorwegian Institute of Public Health, Oslo, NorwayCommon Management Unit (HIV/AIDS, TB & Malaria), Islamabad, PakistanCentre for Operational Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; The Union South-East Asia Office, New Delhi, India; Yenepoya Medical College, Yenepoya (deemed to be University), Mangaluru, IndiaBackground: Pakistan implemented initiatives to detect tuberculosis (TB) patients through extended contact screening (ECS); it improved case detection but treatment outcomes need assessment. Objectives: To compare treatment outcomes of pulmonary TB (PTB) patients detected by ECS with those detected by routine passive case finding (PCF). Methods: A cohort study using secondary program data conducted in Lahore, Faisalabad and Rawalpindi districts and Islamabad in 2013–15. We used log binomial regression models to assess if ECS was associated with unfavorable treatment outcomes (death, loss-to-follow-up, failure, not evaluated) after adjusting for potential confounders. Results: We included 79,431 people with PTB; 4604 (5.8%) were detected by ECS with 4052 (88%) bacteriologically confirmed. In all PTB patients the proportion with unfavorable outcomes was not significantly different in ECS group (9.6%) compared to PCF (9.9%), however, among bacteriologically confirmed patients unfavorable outcomes were significantly lower in ECS (9.9%) than PCF group (11.6%, P = 0.001). ECS was associated with a lower risk of unfavorable outcomes (adjusted relative risk (aRR) 0.90; 95% CI 0.82–0.99) among ‘all PTB’ patients and bacteriologically confirmed PTB patients (aRR 0.91; 95% CI 0.82–1.00). Conclusion: In PTB patients detected by ECS the treatment outcomes were not inferior to those detected by PCF.http://www.sciencedirect.com/science/article/pii/S1201971221000655Pulmonary tuberculosisTreatment outcomesExtended contact screeningPassive case findingsFavorable and unfavorable outcomes |
| spellingShingle | Mahboob Ul Haq Sven G. Hinderaker Razia Fatima Hemant Deepak Shewade Einar Heldal Abdullah Latif Ajay M.V. Kumar Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes? International Journal of Infectious Diseases Pulmonary tuberculosis Treatment outcomes Extended contact screening Passive case findings Favorable and unfavorable outcomes |
| title | Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes? |
| title_full | Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes? |
| title_fullStr | Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes? |
| title_full_unstemmed | Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes? |
| title_short | Extending contact screening within a 50-m radius of an index tuberculosis patient using Xpert MTB/RIF in urban Pakistan: Did it impact treatment outcomes? |
| title_sort | extending contact screening within a 50 m radius of an index tuberculosis patient using xpert mtb rif in urban pakistan did it impact treatment outcomes |
| topic | Pulmonary tuberculosis Treatment outcomes Extended contact screening Passive case findings Favorable and unfavorable outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221000655 |
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