The impact of chest radiography and Xpert MTB/RIF testing among household contacts in Chennai, India

Autor: Jacob Creswell, Lavanya Jayabal, Nalini Karunakaran, Sheela Auguesteen, Andrew J. Codlin, Ramya Ananthakrishnan, Rajeswaran Thiagesan, Robert Stevens, Jagadeesan M
Rok vydání: 2020
Předmět:
Bacterial Diseases
Male
Health Screening
Physiology
Radiography
Smear microscopy
Geographical Locations
Medical Conditions
0302 clinical medicine
Medicine and Health Sciences
Coughing
Mass Screening
Public and Occupational Health
030212 general & internal medicine
Microscopy
Multidisciplinary
Diagnostic test
Middle Aged
Body Fluids
Infectious Diseases
Molecular Diagnostic Techniques
Tuberculosis Diagnosis and Management
Medicine
Female
Anatomy
Rifampin
Research Article
Adult
medicine.medical_specialty
Asia
X-Ray Microscopy
Tuberculosis
Adolescent
Screening test
Science
030231 tropical medicine
India
Research and Analysis Methods
Young Adult
03 medical and health sciences
Signs and Symptoms
Diagnostic Medicine
Internal medicine
Drug Resistance
Bacterial
medicine
Humans
Antibiotics
Antitubercular
Tuberculosis
Pulmonary
Retrospective Studies
Bacteria
business.industry
Sputum
Organisms
Biology and Life Sciences
Retrospective cohort study
Mycobacterium tuberculosis
Tropical Diseases
medicine.disease
Mucus
People and Places
Reagent Kits
Diagnostic
Clinical Medicine
Contact Tracing
Physiological Processes
business
Contact tracing
Zdroj: PLoS ONE, Vol 15, Iss 11, p e0241203 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Tuberculosis prevalence surveys have demonstrated the benefit of screening with chest x-ray (CXR) and sensitive diagnostic tests compared to symptoms and smear microscopy. However, in programmatic practice there is little evidence on the yield of different algorithms. We implemented contact tracing in Chennai, India for adult sputum-positive TB patients registered from January 2015 to March 2016. Patients with symptoms or abnormal X-ray findings further underwent testing using Xpert MTB/RIF (Xpert) and smear microscopy. A retrospective cohort study was done to summarize the key findings. We verbally screened 5553 contacts for symptoms, CXR through private sector collaboration, Xpert, and smear microscopy. Overall, 1312 (23.6%) contacts screened positive. CXR alone identified 531 (40.5%) of them, 679 (51.8%) were symptom-positive only, while 102 (7.8%) were positive on both the symptom and CXR screen. Overall, 35 bacteriologically positive cases were identified (0.7%). A standard approach of symptoms screening followed by microscopy identified only 9 (25.7%) of the total number of bacteriologically positive cases, whereas the combination of a CRX screening followed by microscopy identified 13 (37.1%) of the cases. The algorithm of symptoms screening followed by Xpert testing, detected 20 cases, whereas the combination of symptoms and CXR followed by Xpert increased this number to 35 (75% increase compared to symptoms and Xpert). Optimal use of more sensitive screening tests, better diagnostic tests, and novel private sector engagement can improve diagnostic yield in a programmatic setting.
Databáze: OpenAIRE
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