Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar.
Nang Thu Thu KyawAung SithuSrinath SatyanarayanaAjay M V KumarSaw TheinAye Myat ThiPyae Phyo WaiYan Naing LinKhine Wut Yee KyawMoe Myint Theingi TunMyo Minn OoSi Thu AungAnthony David HarriesPublished in: Tropical medicine and infectious disease (2019)
Screening of household contacts of patients with multidrug-resistant tuberculosis (MDR-TB) is a crucial active TB case-finding intervention. Before 2016, this intervention had not been implemented in Myanmar, a country with a high MDR-TB burden. In 2016, a community-based screening of household contacts of MDR-TB patients using a systematic TB-screening algorithm (symptom screening and chest radiography followed by sputum smear microscopy and Xpert-MTB/RIF assays) was implemented in 33 townships in Myanmar. We assessed the implementation of this intervention, how well the screening algorithm was followed, and the yield of active TB. Data collected between April 2016 and March 2017 were analyzed using logistic and log-binomial regression. Of 620 household contacts of 210 MDR-TB patients enrolled for screening, 620 (100%) underwent TB symptom screening and 505 (81%) underwent chest radiography. Of 240 (39%) symptomatic household contacts, 71 (30%) were not further screened according to the algorithm. Children aged <15 years were less likely to follow the algorithm. Twenty-four contacts were diagnosed with active TB, including two rifampicin- resistant cases (yield of active TB = 3.9%, 95% CI: 2.3%-6.5%). The highest yield was found among children aged <5 years (10.0%, 95% CI: 3.6%-24.7%). Household contact screening should be strengthened, continued, and scaled up for all MDR-TB patients in Myanmar.
Keyphrases
- mycobacterium tuberculosis
- multidrug resistant
- pulmonary tuberculosis
- end stage renal disease
- randomized controlled trial
- ejection fraction
- newly diagnosed
- chronic kidney disease
- machine learning
- peritoneal dialysis
- drug resistant
- young adults
- deep learning
- healthcare
- emergency department
- type diabetes
- gram negative
- patient reported
- prognostic factors
- magnetic resonance imaging
- metabolic syndrome
- hepatitis c virus
- escherichia coli
- human immunodeficiency virus
- adipose tissue
- artificial intelligence
- neural network
- image quality
- glycemic control
- single cell
- hiv aids