Impact of Active Case Finding on Treatment Outcomes in Adult Pulmonary Tuberculosis Patients
https://doi.org/10.21292/2075-1230-2021-99-7-33-40
Abstract
The objective: to assess the effect of active finding of tuberculosis cases on the frequency of bacterial excretion, lung tissue destruction, and treatment outcomes.
Subjects and Methods. The characteristics of adult patients (newly detected - new cases and those with relapsed pulmonary tuberculosis) were studied in 2 phases: a) 1,404 cases, including 814 actively found, at detection; b) the outcomes of the completed first course of chemotherapy in 946 patients, including 565 actively detected, registered for treatment in 2017 and 2018. Adjusted relative risk (aOR) and statistical significance of differences were calculated.
Results. Patients detected actively versus those detected by self presentation to a medical unit had a lower level of positive results of smear microscopy (aOR = 2.7; p < 0.01) and lung tissue destruction (aOR = 1.4; p = 0.01), but the level of positive culture was equal (aOR = 0.9; p = 0.6). Active case finding had no effect on treatment failure rate but if a patient is HIV negative and young, it reduced the risk of death in tuberculosis patients during treatment (aOR = 0.3; p < 0.01). Active case finding, along with no history of previous treatment, negative HIV status, and older age were inversely associated with treatment interruption (aOR = 0.3; p < 0.01).
About the Authors
S. А. Sterlikov
Federal Research Institute for Health Organization and Informatics
Russian Federation
Russian Federation
Sergey A. Sterlikov – Doctor of Medical Sciences, Deputy Head for Program Monitoring of Federal Monitoring Center for Prevention of Tuberculosis Transmission in the Russian Federation
SPIN: 8672-4853
11, Dobrolyubova St., Moscow, 127254.
V. B. Gаlkin
St. Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
Vladimir B. Galkin – Candidate of Medical Sciences, Leading Researcher
SPIN: 9601-5362
2-4, Ligovsky Ave., St. Petersburg, 191036
B. M. Mаliev
North Ossetia State Medical Academy
Russian Federation
Russian Federation
Batarbek M. Maliev – Doctor of Medical Sciences, Professor, Head of Phthisiopulmonology Department
40, Pushkinskaya St., Vladikavkaz, the Republic of North Ossetia– Alania, 362019.
А. А. Shirokovа
Murmansk Regional TB Dispensary
Russian Federation
Russian Federation
Anastasia A. Shirokova – Phthisiologist of Department for Tuberculosis Monitoring, Statistics, Reporting and Prevention Activities
12, Admirala Flota Lobova St., Murmansk, 183034.
V. А. Khorotetto
Yamalo-Nenets Regional TB Dispensary
Russian Federation
Russian Federation
Vladimir A. Khorotetto – Deputy Head Physician on Reporting and Statistics
SPIN: 3963-7062
6, Michurina St.,Salekhard, 629001.
А. S. Mаyzhegishevа
Chukotka Regional Hospital
Russian Federation
Russian Federation
Ardak S. Mayzhegisheva – Head of Pulmonary Tuberculosis Department
51, Partizanskaya St., Anadyr, 689000.
References
1. Borodulina E.V., Borodulina E.А., Gladunova E.P., Vdoushkina E.S. Medical and social characteristics of new tuberculosis patients. Meditsinsky Alyans, 2018, no. 3, pp. 41-46. (In Russ.).
2. Kaminskiy G.D., Kudlay D.А., Panova А.E., Parolina L.E., Peregudova А.B., Pshenichnaya N.Yu., Samoylova А.G., Testov V.V., Tinkova V.V. Taktika vracha pri vyyavlenii, diagnostike i profilaktike sochetannoy infektsii VICH i tuberkulez: prakticheskoe rukovodstvo. [Tactics of the physician in the detection, diagnosis and prevention of TB/HIV coinfection. Practical guide]. I.A. Vasilyeva eds., Moscow, 2020, 152 p.
3. Koretskaya N., Narkevich A. On advantages of active case finding of pulmonary tuberculosis. Vrach, 2013, no. 7, pp. 87-88. (In Russ.).
4. Nechaeva O.B. TB situation in Russia.Tuberculosis and Lung Diseases, 2018,
5. vol. 95, no. 8, pp. 15-24. (In Russ.).
6. Yablonskiy P.K. The Russian phthisiology - the choice of the way for further development. Meditsinsky Alyans, 2013, no. 3, pp. 5-24. (In Russ.).
7. Balcha T.T., Skogmar S., Sturegard E., Bjorkman P., Winqvist N. Outcome of tuberculosis treatment in HIV-positive adults diagnosed through active versus passive case-finding. Global Health Action, 2015, no. 8, doi: 10.3402/gha.v8.27048.
8. Definitions and reporting framework for tuberculosis 2013 revision. WHO/HTM/TB/2013.2. (http://apps.who.int/iris/bitstream/10665/79199/1/9789241505345_eng.pdf?ua=1 Accessed as of: 18.04.2020).
9. Khaing P.S., Kyaw N. T.T., Satyanarayana S., Oo N.L., Aung T.H., Oo H.M., Kyaw K.W.Y., Soe K.T., Thein S., Thwin T., Aung S.T. Treatment outcome of tuberculosis patients detected using accelerated vs. passive case finding in Myanmar. Intern. J. Tuberc. Lung Dis., 2018, vol. 22, no. 10, pp. 1145-1151. doi: 10.5588/ijtld.18.0038.
10. Myint O., Saw S., Isaakidis P., Khogali M., Reid A., Hoa N.B., Kyaw T.T., Zaw K.K., Khaing T.M.M., Aung S.T. Active Case-Finding for Tuberculosis by Mobile Teams in Myanmar: Yield and Treatment Outcomes. Infect. Dis. Poverty, 2017, vol. 6, no. 1, pp. 77, doi: 10.1186/s40249-017-0291-5.
11. Paquette K., Cheng M.P., Kadatz M.J., Cook V.J., Chen W., Johnston J.C. Chest radiography for active tuberculosis case finding in the homeless: a systematic review and meta-analysis. Intern. J. Tuberc. Lung Diseases, 2014, vol. 18, no. 10, pp. 1231-1236. doi: 10.5588/ijtld.14.0105.
12. Prathiksha G., Daniel B.D., Natrajan M. Active case-finding for tuberculosis in India. Natl. Med. J. India, 2019, vol. 32, no. 2, pp. 90-94. doi: 10.4103/0970-258X.275349.
13. Saunders M.J., Tovar M.A., Collier D., Baldwin M.R., Montoya R., Valencia T.R., Gilman P.R.H., Evans P.C.A. Active and passive case-finding in tuberculosis-affected households in Peru: a 10-year prospective cohort study. Lancet Infect. Dis., 2019, vol. 19, no. 5, pp. 519-528. doi: 10.1016/S1473-3099(18)30753-9.
14. Shewade H.D., Gupta V., Satyanarayana S., Kumar S., Pandey P., Bajpai U.N., Tripathy J.P., Kathirvel S., Pandurangan S., Mohanty S., Ghule V.H., Sagili K.D., Prasad B.M., Singh P., Singh K., Jayaraman G., Rajeswaran P., Biswas M., Mallick G., Naqvi A.J., Bharadwaj A.K., Sathiyanarayanan K., Pathak A., Mohan N., Rao R., Kumar A.M.V., Chadha S.S. Active versus passive case finding for tuberculosis in marginalised and vulnerable populations in India: comparison of treatment outcomes. J. Global Infectious Dis., 2019, vol. 12, no. 1, pp. 28-33. DOI: 10.4103/jgid.jgid_66_19.
15. Singh M., Sagili K.D., Tripathy J.P., Kishore S., Bahurupi Y.A., Kumar A., Kala V., Yadav V., Murmu S. Are treatment outcomes of patients with tuberculosis detected by active case finding different from those detected by passive case finding? J. Global Infect. Dis., 2020, vol. 12, no. 1, pp. 28-33. doi: 10.4103/jgid.jgid_66_19.
16. The END TB strategy: WHO/HTM/TB/2015.19 (https://www.who.int/tb/End_TB_brochure.pdf?ua=1 Accessed as of: 25.03.2020).
17. Transforming our world: the 2030 Agenda for Sustainable Development. (https://sustainabledevelopment.un.org/post2015/transformingourworld Accessed as of: 25.03.2020).
Review
For citations:
Sterlikov S.А., Gаlkin V.B., Mаliev B.M., Shirokovа А.А., Khorotetto V.А., Mаyzhegishevа А.S. Impact of Active Case Finding on Treatment Outcomes in Adult Pulmonary Tuberculosis Patients. Tuberculosis and Lung Diseases. 2021;99(7):33-40. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-7-33-40
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