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 |
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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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