1
|
Rudolf F, Abate E, Moges B, Gomes VF, Mendes AM, Sifna A, Fekadu H, Bizuneh S, Wejse C, Schön T. A structured 2-week follow-up visit in the cascade of care for TB increases case detection. Int J Tuberc Lung Dis 2024; 28:148-153. [PMID: 38454179 DOI: 10.5588/ijtld.23.0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVES Delayed detection in TB due to structural and diagnostic shortcomings is pivotal for disease transmission, morbidity and mortality. We investigated whether an inclusive screening, followed by a structured clinical follow-up (FU) could improve case-finding.METHODS Patients were recruited from health centres in Bissau, Guinea-Bissau, and Gondar, Ethiopia. A routine FU was done at Week 2. If persisting symptoms were found, patients were investigated using chest X-ray (CXR) and Xpert® MTB/RIF, followed by a medical consultation. The main outcome were additional TB patients diagnosed by applying the FU strategy.RESULTS Of 3,571 adults, 3,285 (95%) were examined at Week 2 FU, where 2,491 (72%) were asymptomatic. Screening patients presenting with cough >2 weeks alone contributed to the diagnosis of 93 patients (45% of all patients diagnosed here), whereas a TBscore >3 increased this by 18 (9%); adding a Week 2 FU yielded an additional 94 (46%) patients. Among the 794 (24%) with persisting symptoms, 25 were diagnosed using Xpert and 69 at clinical FU, which constituted 46% (94/205) of the total TB patients diagnosed.CONCLUSION A Week 2 FU visit, which can be nested into routine healthcare, increased the diagnosis of TB patients by two-fold and avoids diagnostic gaps in the cascade-of-care..
Collapse
Affiliation(s)
- F Rudolf
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau;, Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - E Abate
- Ethiopian Public Health Institute, Addis Ababa, Tropical & Infectious Diseases Research Center, University of Gondar, Gondar, Ethiopia
| | - B Moges
- Tropical & Infectious Diseases Research Center, University of Gondar, Gondar, Ethiopia
| | - V F Gomes
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau;, Programa Nacional de Luta contra a Tuberculose, Ministério da Saúde, Bissau, Guinéa-Bissau
| | - A M Mendes
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau
| | - A Sifna
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau;, Programa Nacional de Luta contra a Tuberculose, Ministério da Saúde, Bissau, Guinéa-Bissau
| | - H Fekadu
- Department of Internal Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - S Bizuneh
- Department of Internal Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - C Wejse
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau;, Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark;, GloHAU, Center for Global Health, School of Public Health, Aarhus University, Aarhus, Denmark
| | - T Schön
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping
| |
Collapse
|