A role for community-level socioeconomic indicators in targeting tuberculosis screening interventions.

Autor: Brooks MB; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA. Meredith_Brooks@hms.harvard.edu.; Harvard Medical School Center for Global Health Delivery, Boston, MA, USA. Meredith_Brooks@hms.harvard.edu., Jenkins HE; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA., Puma D; Socios En Salud Sucursal Peru, Lima, Peru., Tzelios C; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.; Socios En Salud Sucursal Peru, Lima, Peru., Millones AK; Socios En Salud Sucursal Peru, Lima, Peru., Jimenez J; Socios En Salud Sucursal Peru, Lima, Peru., Galea JT; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.; School of Social Work, University of South Florida, Tampa, FL, USA.; College of Public Health, University of South Florida, Tampa, FL, USA., Lecca L; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.; Socios En Salud Sucursal Peru, Lima, Peru., Becerra MC; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.; Harvard Medical School Center for Global Health Delivery, Boston, MA, USA., Keshavjee S; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.; Harvard Medical School Center for Global Health Delivery, Boston, MA, USA.; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA., Yuen CM; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.; Harvard Medical School Center for Global Health Delivery, Boston, MA, USA.; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2022 Jan 17; Vol. 12 (1), pp. 781. Date of Electronic Publication: 2022 Jan 17.
DOI: 10.1038/s41598-022-04834-7
Abstrakt: Tuberculosis screening programs commonly target areas with high case notification rates. However, this may exacerbate disparities by excluding areas that already face barriers to accessing diagnostic services. We compared historic case notification rates, demographic, and socioeconomic indicators as predictors of neighborhood-level tuberculosis screening yield during a mobile screening program in 74 neighborhoods in Lima, Peru. We used logistic regression and Classification and Regression Tree (CART) analysis to identify predictors of screening yield. During February 7, 2019-February 6, 2020, the program screened 29,619 people and diagnosed 147 tuberculosis cases. Historic case notification rate was not associated with screening yield in any analysis. In regression analysis, screening yield decreased as the percent of vehicle ownership increased (odds ratio [OR]: 0.76 per 10% increase in vehicle ownership; 95% confidence interval [CI]: 0.58-0.99). CART analysis identified the percent of blender ownership (≤ 83.1% vs > 83.1%; OR: 1.7; 95% CI: 1.2-2.6) and the percent of TB patients with a prior tuberculosis episode (> 10.6% vs ≤ 10.6%; OR: 3.6; 95% CI: 1.0-12.7) as optimal predictors of screening yield. Overall, socioeconomic indicators were better predictors of tuberculosis screening yield than historic case notification rates. Considering community-level socioeconomic characteristics could help identify high-yield locations for screening interventions.
(© 2022. The Author(s).)
Databáze: MEDLINE
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