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Brigden G, Sagili K, Dlodlo RA. Occupational safety and health for respiratory health: a comprehensive approach for an often-forgotten issue. Int J Tuberc Lung Dis 2022; 26:183-185. [PMID: 35197157 DOI: 10.5588/ijtld.21.0685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- G Brigden
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - K Sagili
- TB and Communicable Diseases, The Union South East Asia Office, New Delhi, India
| | - R A Dlodlo
- Department of Tuberculosis, The Union, Bulawayo, Zimbabwe
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Prabhu A, Agarwal U, Tripathy JP, Singla N, Sagili K, Thekkur P, Sarin R. "99DOTS"techno-supervision for tuberculosis treatment - A boon or a bane? Exploring challenges in its implementation at a tertiary centre in Delhi, India. Indian J Tuberc 2019; 67:46-53. [PMID: 32192617 DOI: 10.1016/j.ijtb.2019.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 08/14/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND In India, daily regimen with fixed-dose combination along with 99DOTS adherence tool and one-stop service at Anti-Retroviral Treatment (ART) centres for HIV infected Tuberculosis (TB) patients was launched in 2017. No systematic evaluation of its implementation has been done so far in a tertiary care setting in urban India. METHODS A mixed-methods study was conducted at National Institute of Tuberculosis and Respiratory Diseases, Delhi in 2018-19. Missed doses, average adherence and treatment outcomes were compared across 99DOTS dashboard and TB treatment card. In-depth interviews of patients and health care providers were conducted to explore the implementation challenges and benefits. RESULTS Median of missed doses recorded during intensive and continuation phase were 56 and 68 respectively in 99DOTS as compared to 0 in the TB Treatment card (p<0.0001). Average adherence was observed to be 27% in 99DOTS versus 99% in the TB treatment card (p<0.0001). Technical issues like software malfunction, logistic difficulties such as missing custom envelops and patient's inability to give call were reported. Role clarity among ART and TB program staff was ambiguous, which contributed to poor information flow between them. Patient benefits such as reduced stigma, less travel costs and reduced work absenteeism were reported. CONCLUSION Success of 99DOTS program under programmatic condition needs webtool stability, uninterrupted logistic supplies (envelops), training of staff and better coordination between TB and HIV program personnel. Despite the challenges in its implementation, the benefit of this tool in terms of greater convenience and reduced stigma for patients is encouraging.
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Affiliation(s)
- Ananya Prabhu
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
| | - Upasna Agarwal
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Neeta Singla
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | | | - Pruthu Thekkur
- The Union South East Asia Office, New Delhi, India; Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - Rohit Sarin
- National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
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Chadha S, Kundu D, Sagili K, Das A. Byssinosis and tuberculosis amongst "home-based" powerloom workers in Madhya Pradesh State, India. Indian J Tuberc 2019; 66:407-410. [PMID: 31439188 DOI: 10.1016/j.ijtb.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 08/16/2018] [Accepted: 01/08/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Byssinosis is an occupational lung disease observed among workers exposed to cotton, flax, and hemp dust. The severity and extent of Byssinosis are well recognised in the high-income countries and control measures have been implemented to prevent the disease. In India, there are conflicting evidence on burden estimation of the disease, followed by inadequate prevention and control of Byssinosis. DESIGN/METHODS We did a cross-sectional study to assess the prevalence of Byssinosis in "home-based" power-loom workers in Mominpura, an administrative ward of Burhanpur Municipality with 2800 population in the state of Madhya Pradesh, India. 290 adults working from "home-based" power loom units were randomly selected, profiled and screened for Byssinosis like symptoms with the help of a semi-structured questionnaire and simple hand-held peak expiratory flow monitor. For epidemiological purposes the symptoms were classified based on Schilling's classification. Chest x-rays were done for selected subjects. Sputum smear microscopy for detecting TB was done for those who had Byssinosis like symptoms. RESULTS Prevalence of Byssinosis among "home based" powerloom workers was found to be 98% [n = 283, 95 CI (95.65-98.96)]. Peak expiratory flow rate (PEFR) was reduced in 44% (n = 124), of which 81 (29%) had more than 50% PEFR reduction, and of these, 69 (29%) were in early stage of Byssinosis (Grade 0.5). 11% of study participants who had Byssinosis like symptoms, also had TB. CONCLUSIONS Byssinosis is highly prevalent in "home-based" power loom units in Madhya Pradesh. Adequate advocacy on awareness and prevention; prompt diagnosis and linkages to treatment services in "home-based" power loom units are urgently required to address Byssinosis at an early disease stage.
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Affiliation(s)
- Sarabjit Chadha
- International Union Against Tuberculosis and Lung Disease (The Union) South East Asia Office, New Delhi, India
| | - Debashish Kundu
- International Union Against Tuberculosis and Lung Disease (The Union) South East Asia Office, New Delhi, India.
| | - Karuna Sagili
- International Union Against Tuberculosis and Lung Disease (The Union) South East Asia Office, New Delhi, India
| | - Anand Das
- International Union Against Tuberculosis and Lung Disease (The Union) South East Asia Office, New Delhi, India
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Madan C, Chopra KK, Satyanarayana S, Surie D, Chadha V, Sachdeva KS, Khanna A, Deshmukh R, Dutta L, Namdeo A, Shukla A, Sagili K, Chauhan LS. Developing a model to predict unfavourable treatment outcomes in patients with tuberculosis and human immunodeficiency virus co-infection in Delhi, India. PLoS One 2018; 13:e0204982. [PMID: 30281679 PMCID: PMC6169917 DOI: 10.1371/journal.pone.0204982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/18/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) patients with human immunodeficiency virus (HIV) co-infection have worse TB treatment outcomes compared to patients with TB alone. The distribution of unfavourable treatment outcomes differs by socio-demographic and clinical characteristics, allowing for early identification of patients at risk. OBJECTIVE To develop a statistical model that can provide individual probabilities of unfavourable outcomes based on demographic and clinical characteristics of TB-HIV co-infected patients. METHODOLOGY We used data from all TB patients with known HIV-positive test results (aged ≥15 years) registered for first-line anti-TB treatment (ATT) in 2015 under the Revised National TB Control Programme (RNTCP) in Delhi, India. We included variables on demographics and pre-treatment clinical characteristics routinely recorded and reported to RNTCP and the National AIDS Control Organization. Binomial logistic regression was used to develop a statistical model to estimate probabilities of unfavourable TB treatment outcomes (i.e., death, loss to follow-up, treatment failure, transfer out of program, and a switch to drug-resistant regimen). RESULTS Of 55,260 TB patients registered for ATT in 2015 in Delhi, 928 (2%) had known HIV-positive test results. Of these, 816 (88%) had drug-sensitive TB and were ≥15 years. Among 816 TB-HIV patients included, 157 (19%) had unfavourable TB treatment outcomes. We developed a model for predicting unfavourable outcomes using age, sex, disease classification (pulmonary versus extra-pulmonary), TB treatment category (new or previously treated case), sputum smear grade, known HIV status at TB diagnosis, antiretroviral treatment at TB diagnosis, and CD4 cell count at ATT initiation. The chi-square p-value for model calibration assessed using the Hosmer-Lemeshow test was 0.15. The model discrimination, measured as the area under the receiver operator characteristic (ROC) curve, was 0.78. CONCLUSION The model had good internal validity, but should be validated with an independent cohort of TB-HIV co-infected patients to assess its performance before clinical or programmatic use.
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Affiliation(s)
| | | | | | - Diya Surie
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vineet Chadha
- National Tuberculosis Institute, Bangalore, Karnataka, India
| | | | | | | | - Lopamudra Dutta
- The United Nations Children's Fund (UNICEF), New Delhi, India
| | - Amit Namdeo
- The United Nations Children's Fund (UNICEF), New Delhi, India
| | - Ajay Shukla
- Uttar Pradesh State AIDS Control Society, Lucknow, Uttar Pradesh, India
| | - Karuna Sagili
- International Union Against Tuberculosis and Lung Disease, New Delhi, India
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Affiliation(s)
- S Chadha
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
| | - A Trivedi
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
| | - S B Nagaraja
- The Department of Community Medicine, Employees State Insurance Corporation (ESIC), Medical College and Post Graduate Institute of Medical Sciences and Research (PGIMSR) Hospital Bangalore, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease South East Asia Office, New Delhi, India
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Sagili K, Chadha S, Satyanarayana S. Tobacco use among tuberculosis patients across 30 districts in India in 2013 and 2017. Tob Induc Dis 2018. [DOI: 10.18332/tid/84747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Waikar S, Pathak A, Ghule V, Kapoor A, Sagili K, Babu ER, Chadha S. Should sputum-negative presumptive TB patients be actively followed to identify missing cases in India? Public Health Action 2017; 7:289-293. [PMID: 29584796 DOI: 10.5588/pha.17.0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/07/2017] [Indexed: 11/10/2022] Open
Abstract
Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.
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Affiliation(s)
- S Waikar
- Population Services International, New Delhi, India
| | - A Pathak
- Population Services International, New Delhi, India
| | - V Ghule
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| | - A Kapoor
- Population Services International, New Delhi, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| | - E R Babu
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
| | - S Chadha
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India
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Chadha S, Trivedi A, Nagaraja SB, Sagili K. Using mHealth to enhance TB referrals in a tribal district of India. Public Health Action 2017; 7:123-126. [PMID: 28695085 DOI: 10.5588/pha.16.0080] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background: A mobile health (mHealth) technology based application was developed to help rural health care providers (RHCPs) identify and refer presumptive tuberculosis (TB) patients to the nearest microscopy centre for sputum examination using mobile applications on their smart phones. Objective: To determine the feasibility and yield of presumptive TB case referrals by RHCPs using mHealth technology. Methods: The project was implemented in the tribal population of Khunti District, Jharkhand State, India, from April 2012 to February 2015. 'ComCare', a mobile application designed as an aid for health care providers, was introduced and RHCPs were trained in its use. Results: Of 171 RHCPs who were formally trained to identify and refer presumptive TB patients, 30 were trained in the use of the mobile application. There were 35 referrals of presumptive TB patients per RHCP using the mobile application, and four each by RHCPs who were not using the application. Of the 194 TB cases diagnosed, RHCPs using the application contributed 127 (i.e., 4 TB cases per RHCP), while other RHCPs contributed 67 (0.5 TB case per RHCP). Conclusion: mHealth technology was highly effective, and increased both public and private health care provider accountability to patients.
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Affiliation(s)
- S Chadha
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - A Trivedi
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
| | - S B Nagaraja
- The Department of Community Medicine, Employees State Insurance Corporation (ESIC), Medical College and Post Graduate Institute of Medical Sciences and Research (PGIMSR), Bangalore, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease South-East Asia Office, New Delhi, India
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Shewade HD, Chadha SS, Gupta V, Tripathy JP, Satyanarayana S, Sagili K, Mohanty S, Bera OP, Pandey P, Rajeswaran P, Jayaraman G, Santhappan A, Bajpai UN, Mamatha AM, Maiser R, Naqvi AJ, Pandurangan S, Nath S, Ghule VH, Das A, Prasad BM, Biswas M, Singh G, Mallick G, Jeyakumar Jaisingh AJ, Rao R, Kumar AMV. Data collection using open access technology in multicentre operational research involving patient interviews. Public Health Action 2017; 7:74-77. [PMID: 28744430 DOI: 10.5588/pha.15.0079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 11/19/2016] [Indexed: 11/10/2022] Open
Abstract
Conducting multicentre operational research is challenging due to issues related to the logistics of travel, training, supervision, monitoring and troubleshooting support. This is even more burdensome in resource-constrained settings and if the research includes patient interviews. In this article, we describe an innovative model that uses open access tools such as Dropbox, TeamViewer and CamScanner for efficient, quality-assured data collection in an ongoing multicentre operational research study involving record review and patient interviews. The tools used for data collection have been shared for adaptation and use by other researchers.
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Affiliation(s)
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - V Gupta
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,All India Institute of Medical Sciences, New Delhi, India
| | - J P Tripathy
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - K Sagili
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Mohanty
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - O P Bera
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - P Pandey
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - P Rajeswaran
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - G Jayaraman
- Resource Group for Education and Advocacy for Community Health, Chennai, India
| | - A Santhappan
- Catholic Health Association of India, Secunderabad, India
| | - U N Bajpai
- Voluntary Health Association of India, New Delhi, India
| | - A M Mamatha
- Catholic Health Association of India, Secunderabad, India
| | - R Maiser
- Catholic Health Association of India, Secunderabad, India
| | - A J Naqvi
- MAMTA Health Institute for Mother and Child, New Delhi, India
| | - S Pandurangan
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - S Nath
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - V H Ghule
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - A Das
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - B M Prasad
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - M Biswas
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - G Singh
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - G Mallick
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | | | - R Rao
- Central TB Division, Revised National Tuberculosis Control Programme, Ministry of Health and Family Welfare, New Delhi, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,The Union, Paris, France
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Abstract
India accounts for the highest number of incident tuberculosis (TB) cases globally. Hence, to impact the TB incidence world over, there is an urgent need to address and accelerate TB control activities in the country. Nearly, half of the TB patients first seek TB care in private sector. However, the participation of private practitioners (PPs) has been patchy in TB prevention and care and distrust exists between public and private sector. PPs usually have varied diagnostic and treatment practices that are inadequate and amplify the risk of drug resistance. Hence, their regulation and involvement as key stakeholders are important in TB prevention and care in India if we are to achieve TB control at global level. However, there remain certain barriers and gaps, which are preventing their upscaling. The current paper aims to discuss the status of private sector involvement in TB prevention and care in India. The paper also discusses the strategies and initiatives taken by the government in this regard as evidence shows that the involvement of private sector in co-opting directly observed treatment short-course (DOTS) helps to enhance case finding and treatment outcomes; it improves the accessibility of quality TB care with greater geographic coverage. Besides public-private mix, DOTS has been found more cost-effective and reduces financial burden of patients. The paper also offers to present some more solutions both at policy and program level for upscaling the engagement of PPs in the national TB control program.
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Affiliation(s)
- Tanu Anand
- North Delhi Municipal Corporation Medical College, Hindu Rao Hospital, New Delhi, India
| | - Ranjith Babu
- International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India
| | - Anil G Jacob
- International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India
| | - Karuna Sagili
- International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India
| | - Sarabjit S Chadha
- International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India
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Satyanarayana S, Sagili K, Chadha SS, Pai M. Use of rapid point-of-care tests by primary health care providers in India: findings from a community-based survey. Public Health Action 2015; 4:249-51. [PMID: 26400704 DOI: 10.5588/pha.14.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
In a cross-sectional survey conducted in 45 districts of India, we assessed 1) use of any rapid point-of-care (POC) tests by primary health care providers, and 2) their willingness to use POC tests for tuberculosis (TB) in future. A total of 767 primary health care providers, including private and public sector practitioners, health workers and chemists, were interviewed. A quarter of the primary health care providers reported using POC tests, with pregnancy tests being the most common. Nearly half of the respondents expressed willingness to use POC tests for TB, provided the test was available free or at low cost (<US$ 2.00).
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Affiliation(s)
- S Satyanarayana
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, and McGill International TB Centre, Montreal, Quebec, Canada ; Centre for Operations Research, International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
| | - K Sagili
- The Union, South-East Asia Regional Office, New Delhi, India
| | - S S Chadha
- The Union, South-East Asia Regional Office, New Delhi, India
| | - M Pai
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, and McGill International TB Centre, Montreal, Quebec, Canada
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12
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Reza LW, Satyanarayna S, Enarson DA, Kumar AMV, Sagili K, Kumar S, Prabhakar LA, Devendrappa NM, Pandey A, Wilson N, Chadha S, Thapa B, Sachdeva KS, Kohli MP. LED-fluorescence microscopy for diagnosis of pulmonary tuberculosis under programmatic conditions in India. PLoS One 2013; 8:e75566. [PMID: 24130719 PMCID: PMC3794029 DOI: 10.1371/journal.pone.0075566] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 08/15/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Light-emitting diode fluorescence microscopy (LED-FM) has been shown to be more sensitive than conventional bright field microscopy using Ziehl-Neelsen (ZN) stain in detecting sputum smear positive tuberculosis in controlled laboratory conditions. In 2012, Auramine O staining based LED-FM replaced conventional ZN microscopy in 200 designated microscopy centres (DMC) of medical colleges operating in collaboration with India's Revised National Tuberculosis Control Programme. We aimed to assess the impact of introduction of LED-FM services on sputum smear positive case detection under program conditions. METHODS This was a before and after comparison study. In 15 randomly selected medical college DMCs, all presumptive TB patients who underwent sputum smear examination in the years 2011 (before LED-FM) and 2012 (after LED-FM) were compared. An additional 15 comparable DMCs that implemented conventional ZN sputum smear microscopy were also selected for comparison between 2011 and 2012. RESULTS The proportion of presumptive TB patients (PTP)found sputum smear positive increased by 30%- from 13.6% (3432/25159) in 2011 to 17.8% (4706/26426) in 2012 (P value <0.01) in the sites that implemented LED-FM microscopy, whereas in DMCs where the ZN staining procedure is followed the proportion of sputum smear positive had remained unchanged (13.0%versus 12.6%;P value0.31). CONCLUSION Use of LED-FM significantly increased the proportion of smear positive cases among presumptive TB patients under routine program conditions in high workload laboratories. The study provides operational evidence needed to scale-up the use of LED-FM in similar settings in India and beyond.
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Affiliation(s)
- Lord Wasim Reza
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Srinath Satyanarayna
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Donald A. Enarson
- International Union against Tuberculosis and Lung Disease, Paris, France
| | - Ajay M. V. Kumar
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Karuna Sagili
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Sujeet Kumar
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Levi Anand Prabhakar
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - N. M. Devendrappa
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Ashish Pandey
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Nevin Wilson
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Sarabjit Chadha
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Badri Thapa
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
| | - Kuldeep Singh Sachdeva
- Central TB Division, Directorate general of health services, Ministry of Health and Family Welfare, New Delhi, India
| | - Mohan P. Kohli
- International Union against Tuberculosis and Lung Disease(The Union), South-East Asia Regional Office, New Delhi, India
- Central TB Division, Directorate general of health services, Ministry of Health and Family Welfare, New Delhi, India
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Raju R, Suneetha S, Sagili K, Meher VC, Saraswathi V, Satyanarayana AVV, Suneetha LM. Diagnostic role of the antibody response to the 38kDa, 16kDa proteins and lipoarabinomannan of mycobacterium tuberculosis. Indian J Clin Biochem 2012; 20:123-8. [PMID: 23105508 DOI: 10.1007/bf02893056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The antibody response to the 38kDa, 16kDa and Lipoarabinomannan (LAM) antigens ofMycobacterium tuberculosis was evaluated using three different ELISAs based on these antigens. The study group included tuberculosis patients (n=52), patients with HIV and TB co-infection (n=10), other chest symptomatics (n=5), HIV infected individuals (n=10), leprosy cases (n=7) and healthy controls (n=75). The results indicate that the 38kDa and LAM based ELISA for IgM/IgG has a low specificity (ranging from 69-85%) and sensitivity (ranging from 55-78%). When three ELISAs are carried out on a single patient the probability of detection of tuberculosis was significantly increased to 95.2% indicating that a single ELISA test is of low sensitivity and that a combination of ELISA's may be needed to be of any value as a diagnostic test for tuberculosis. Additionally, a western blot assay of the serum antibody response to protein fraction ofM. tuberculosis was analysed in 15 tuberculosis patients and five healthy controls. A multiple antibody response to various M.tuberculosis proteins was observed which varied from patient to patient as compared to controls who showed a single 38-39 kDa protein band positivity. These finding suggest that a western blot assay which determines the antibody response to a set of antigenic components ofM. tuberculosis could be a better serological test for the diagnosis of tuberculosis in our population.
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Affiliation(s)
- Renuka Raju
- Blue Peter Research Centre, LEPRA India, Hyderabad, India
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