Tuberculosis among drug users and homeless persons: impact of voluntary X-ray investigation on active case finding

Infection ◽  
2012 ◽  
Vol 40 (4) ◽  
pp. 389-395 ◽  
Author(s):  
U. Goetsch ◽  
O. K. Bellinger ◽  
K.-L. Buettel ◽  
R. Gottschalk
Keyword(s):  
Drug Users ◽  
Homeless Persons ◽  
Case Finding ◽  
Active Case Finding ◽  
X Ray ◽  
Active Case

scholarly journals Use of targeted mobile X-ray screening and computer-aided detection software to identify tuberculosis among high-risk groups in Romania: descriptive results of the E-DETECT TB active case-finding project

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045289
Author(s):  
Beatrice Mahler ◽  
Gerard de Vries ◽  
Rob van Hest ◽  
Dan Gainaru ◽  
Dee Menezes ◽  
...  
Keyword(s):  
Drug Users ◽  
Homeless Persons ◽  
Case Finding ◽  
Active Case Finding ◽  
Prevalence Rates ◽  
Computer Aided Detection ◽  
X Ray ◽  
Roma Population ◽  
Computer Aided ◽  
Problem Drug

ObjectiveTo implement and assess the mobile X-ray unit (MXU) equipped with digital radiography, computer-aided detection (CAD) software and molecular point of care tests to improve early tuberculosis (TB) diagnosis in vulnerable populations in a TB outreach screening programme in Romania.DesignDescriptive study.SettingsPrisons in Bucharest and other cities in the southern part of Romania, homeless shelters and services for problem drug users in Bucharest, and Roma populations in Bucharest and Craiova.Participants5510 individuals attended the MXU service; 5003 persons were radiologically screened, 61% prisoners, 15% prison staff, 11% Roma population, 10% homeless persons and/or problem drug users and 3% other.InterventionsRadiological digital chest X-ray (CXR) screening of people at risk for TB, followed by CAD and human reading of the CXRs, and further TB diagnostics when the pulmonologist classified the CXR as suggestive for TB.Primary and secondary outcome measuresTen bacteriologically confirmed TB cases were identified translating into an overall yield of 200 per 100 000 persons screened (95% CIs of 109 to 368 per 100 000). Prevalence rates among homeless persons and/or problem drug users (826/100 000; 95% CI 326 to 2105/100 000) and the Roma population (345/100 000; 95% CI 95 to 1251/100 000) were particularly high.ResultsThe human reader classified 6.4% (n=317) of the CXRs as suspect for TB (of which 32 were highly suggestive for TB); 16.3% of all CXRs had a CAD4TB version 6 score >50. All 10 diagnosed TB patients had a CAD4TB score >50; 9 had a CAD4TB score >60.ConclusionsGiven the high TB prevalence rates found among homeless persons and problem drug users and in the Roma population, targeted active case finding has the potential to deliver a major contribution to TB control in Romania.

Utilizing chest X-ray based active case finding approach for early tuberculosis case detection in Pakistan

2019 ◽  
Author(s):  
Shifa Habib ◽  
Kiran Azeemi ◽  
S. M. Asad Zaidi ◽  
Wafa Jamal ◽  
Talha Kazmi ◽  
...  
Keyword(s):  
Case Finding ◽  
Case Detection ◽  
Active Case Finding ◽  
Tuberculosis Case ◽  
X Ray ◽  
Active Case ◽  
Chest X Ray

scholarly journals Chest x-ray findings in tuberculosis patients identified by passive and active case finding: A retrospective study

2019 ◽  
Vol 14 ◽  
pp. 26-30 ◽  
Author(s):  
Ema Rastoder ◽  
Saher Burhan Shaker ◽  
Matiullah Naqibullah ◽  
Mathilde Marie Winkler Wille ◽  
Mette Lund ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Case Finding ◽  
Active Case Finding ◽  
Tuberculosis Patients ◽  
X Ray ◽  
Active Case ◽  
Chest X Ray

scholarly journals Active detection of tuberculosis: tackling the problem head on in the remote area of Andaman and Nicobar Islands

2019 ◽  
Vol 6 (8) ◽  
pp. 3314
Author(s):  
Samarendra Prasanna Burma ◽  
Gunda Jahnavi ◽  
Pappachen Lal ◽  
Pandurang V. Thatkar
Keyword(s):  
Case Finding ◽  
Nucleic Acid Amplification ◽  
Sputum Smear ◽  
Active Case Finding ◽  
Community Based ◽  
Cross Sectional ◽  
X Ray ◽  
Active Case ◽  
Sputum Microscopy ◽  
Team Activity

Background: Community based active case finding for tuberculosis (TB) is an essential step in the fight forward for eliminating TB. One of the steps in targeting TB intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. Active case finding (ACF) targeting the entire population by house to house survey was done in Nicobar district of these islands.Methods: A community-based, cross-sectional, descriptive study was conducted with the trained mobile teams from 17.07.2017 to 31.07.2017 in the Nicobar District. The algorithm of the case detection included screening patients by symptoms, then by sputum microscopy for confirmation. X-ray was done in patients who were symptomatic but sputum negative. If both smear and chest X-ray results were negative but still symptomatic, then cartridge-based nucleic acid amplification test (CBNAAT) was done.Results: A total population of 18526 was mapped of which 14784 (79.8) could be screened. A total of 209 people were identified by the mobile teams with symptoms who were examined by sputum microscopy. Among them 7 cases were identified to be sputum smear positive, 2 X-ray positive and 2 were diagnosed by CBNAAT.Conclusions: This study shows that the active case finding method is feasible and acceptable by the community. The results obtained are encouraging for the implementation of ACF through mobile team activity in all these islands in order to meet the target of WHO’s End TB Strategy.

scholarly journals Early Evaluation of an Ultra-Portable X-ray System for Tuberculosis Active Case Finding

2021 ◽  
Vol 6 (3) ◽  
pp. 163
Author(s):  
Luan Nguyen Quang Vo ◽  
Andrew Codlin ◽  
Thuc Doan Ngo ◽  
Thang Phuoc Dao ◽  
Thuy Thi Thu Dong ◽  
...  
Keyword(s):  
Image Quality ◽  
Case Finding ◽  
Active Case Finding ◽  
Community Based ◽  
X Ray ◽  
Early Evaluation ◽  
Active Case ◽  
Portable System ◽  
Quality Rating ◽  
Image Quality Rating

X-ray screening is an important tool in tuberculosis (TB) prevention and care, but access has historically been restricted by its immobile nature. As recent advancements have improved the portability of modern X-ray systems, this study represents an early evaluation of the safety, image quality and yield of using an ultra-portable X-ray system for active case finding (ACF). We reported operational and radiological performance characteristics and compared image quality between the ultra-portable and two reference systems. Image quality was rated by three human readers and by an artificial intelligence (AI) software. We deployed the ultra-portable X-ray alongside the reference system for community-based ACF and described TB care cascades for each system. The ultra-portable system operated within advertised specifications and radiologic tolerances, except on X-ray capture capacity, which was 58% lower than the reported maximum of 100 exposures per charge. The mean image quality rating from radiologists for the ultra-portable system was significantly lower than the reference (3.71 vs. 3.99, p < 0.001). However, we detected no significant differences in TB abnormality scores using the AI software (p = 0.571), nor in any of the steps along the TB care cascade during our ACF campaign. Despite some shortcomings, ultra-portable X-ray systems have significant potential to improve case detection and equitable access to high-quality TB care.

scholarly journals Identifying TB hotspots through mobile X-rays in Karachi, Pakistan: spatial analysis of data from an active case-finding program

2021 ◽  
Author(s):  
Syed Mohammad Asad Zaidi ◽  
Wafa Zehra Jamal ◽  
Christina Mergenthaler ◽  
Kiran Sohail Azeemi ◽  
Nick Van Den Berge ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Spatial Autocorrelation ◽  
Case Finding ◽  
World Health ◽  
Moran’S I ◽  
X Rays ◽  
Active Case Finding ◽  
Moran's I ◽  
X Ray ◽  
Active Case

Abstract IntroductionTuberculosis (TB) is the leading cause of avoidable deaths from an infectious disease globally and a large of number of people who develop TB each year remain undiagnosed. Active case-finding has been recommended by the World Health Organization to bridge the case-detection gap for TB in high burden countries. However, concerns remain regarding their yield and cost-effectiveness. MethodsData from mobile chest X-ray (CXR) supported active case-finding community camps conducted in Karachi, Pakistan from July 2017- March 2020 was retrospectively analyzed. After a CXR screening supported by computer-aided detection, those with presumptive TB were counselled to submit a sputum sample for Xpert MTB/RIF testing. Frequency analysis was carried out at the camp-level and outcomes of interest for the spatial analyses were mycobacterium TB positivity (MTB+) and X-ray abnormality ratios. The Moran’s I statistic was used to test for spatial autocorrelation for MTB+ and abnormal X-rays within Union Councils (UCs) in Karachi. Local Indicators of Spatial Autocorrelation analyses were performed for UCs within Karachi. Point-pattern analyses were carried out utilizing GPS coordinates recorded at the camp sites and were analyzed for spatial autocorrelation using Getis Ord Star tests.ResultsA total of 1,161 (78.1%) camps yielded no MTB+ cases, 246 (16.5%) camps yielded 1 MTB+, 52 (3.5%) camps yielded 2 MTB+ and 27 (1.8%) yielded 3 or more MTB+. A total of 79 (5.3%) camps accounted for 193 (44.0%) of MTB+ cases detected. Statistically significant clustering for MTB positivity (Moran’s I: 0.09) and abnormal chest X-rays (Moran’s I: 0.36) ratios was identified within UCs in Karachi. Clustering of UCs with high MTB positivity were identified in Karachi West district. Clusters of camp locations with high MTB+ ratios were identified in Karachi South and Karachi West districts and in several locations in the north and eastern peripheries of the city. ConclusionStatistically significant spatial variation was identified in yield of bacteriologically positive TB cases and in abnormal CXR through active case-finding in Karachi. Cost-effectiveness of active case-finding programs can be improved by identifying and focusing interventions in hotspots and avoiding locations with no known TB cases reported through routine surveillance.

scholarly journals Blood-based host biomarker diagnostics in active case finding for pulmonary tuberculosis: A diagnostic case-control study

2021 ◽  
pp. 100776
Author(s):  
Flora Martinez Figueira Moreira ◽  
Renu Verma ◽  
Paulo Cesar Pereira dos Santos ◽  
Alessandra Leite ◽  
Andrea da Silva Santos ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Case Control Study ◽  
Case Control ◽  
Case Finding ◽  
Active Case Finding ◽  
Active Case ◽  
Control Study

Active case finding of pulmonary TB in a European refugee camp: Lessons learnt from Oinofyta hosting site in Greece

2021 ◽  
Author(s):  
Zisimangelos Solomos ◽  
Chrisoula Botsi ◽  
Theano Georgakopoulou ◽  
Theodore Lytras ◽  
Sotirios Tsiodras ◽  
...  
Keyword(s):  
Refugee Camp ◽  
Case Finding ◽  
Active Case Finding ◽  
Pulmonary Tb ◽  
Active Case ◽  
Lessons Learnt
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