Optimising diagnosis and treatment of tuberculosis infection in community and primary care settings in two urban provinces of Viet Nam: a cohort study
| Autor: | Maxine Caws, Viet Nhung Nguyen, Rachel Forse, Jacob Creswell, Luan Nguyen Quang Vo, Nga Thi Thuy Nguyen, Thuy Thi Thu Dong, Andrew Codlin, Huyen Thanh Truong, Hoa Binh Nguyen, Ha Thi Minh Dang, Vinh Van Truong, Lan Huu Nguyen, Tuan Huy Mac, Phong Thanh Le, Khoa Tu Tran, Nduku Ndunda |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | BMJ Open, Vol 13, Iss 2 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2022-0715 2044-6055 |
| DOI: | 10.1136/bmjopen-2022-071537 |
| Popis: | Objectives To end tuberculosis (TB), the vast reservoir of 1.7–2.3 billion TB infections (TBIs) must be addressed, but achieving global TB preventive therapy (TPT) targets seems unlikely. This study assessed the feasibility of using interferon-γ release assays (IGRAs) at lower healthcare levels and the comparative performance of 3-month and 9-month daily TPT regimens (3HR/9H).Design, setting, participants and intervention This cohort study was implemented in two provinces of Viet Nam from May 2019 to September 2020. Participants included household contacts (HHCs), vulnerable community members and healthcare workers (HCWs) recruited at community-based TB screening events or HHC investigations at primary care centres, who were followed up throughout TPT.Primary and secondary outcomes We constructed TBI care cascades describing indeterminate and positivity rates to assess feasibility, and initiation and completion rates to assess performance. We fitted mixed-effects logistic and stratified Cox models to identify factors associated with IGRA positivity and loss to follow-up (LTFU).Results Among 5837 participants, the indeterminate rate was 0.8%, and 30.7% were IGRA positive. TPT initiation and completion rates were 63.3% (3HR=61.2% vs 9H=63.6%; p=0.147) and 80.6% (3HR=85.7% vs 9H=80.0%; p=0.522), respectively. Being male (adjusted OR=1.51; 95% CI: 1.28 to 1.78; p |
| Databáze: | Directory of Open Access Journals |
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