دورية أكاديمية
Implementation of systematic screening for tuberculosis disease and tuberculosis preventive treatment among people living with HIV attending antiretroviral treatment clinics in Ghana: a national pilot study.
| العنوان: | Implementation of systematic screening for tuberculosis disease and tuberculosis preventive treatment among people living with HIV attending antiretroviral treatment clinics in Ghana: a national pilot study. |
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| المؤلفون: | Adusi-Poku Y; National Tuberculosis Programme, Ghana Health Service, Accra, Ghana., Addai L; Ridge Regional Hospital, Accra, Ghana., Wadie B; National Tuberculosis Programme, Ghana Health Service, Accra, Ghana., Afutu FK; National Tuberculosis Programme, Ghana Health Service, Accra, Ghana., Bruce SAK; National Tuberculosis Programme, Ghana Health Service, Accra, Ghana., Baddoo NA; National AIDS/STI Control Programme, Accra, Ghana., Wagaw ZA; National Tuberculosis Programme, Ghana Health Service, Accra, Ghana., Campbell JR; Department of Medicine, McGill University, Montreal, Quebec, Canada., Merle CS; Special Programme for Research & Training In Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland., Frimpong Amenyo RP; National Tuberculosis Programme, Ghana Health Service, Accra, Ghana ritapatriciafrimpongmansoh@gmail.com.; Ghana College of Physicians and Surgeons, Accra, Ghana. |
| المصدر: | BMJ open [BMJ Open] 2024 May 28; Vol. 14 (5), pp. e083557. Date of Electronic Publication: 2024 May 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BMJ Publishing Group Ltd, 2011- |
| مواضيع طبية MeSH: | HIV Infections*/complications , HIV Infections*/drug therapy , Mass Screening*/economics , Mass Screening*/methods, Humans ; Ghana/epidemiology ; Female ; Male ; Adult ; Pilot Projects ; Prospective Studies ; Middle Aged ; Tuberculosis/prevention & control ; Tuberculosis/diagnosis ; Tuberculosis/epidemiology ; Anti-Retroviral Agents/therapeutic use |
| مستخلص: | Objectives: To assess the yield and cost of implementing systematic screening for tuberculosis (TB) disease among people living with HIV (PLHIV) and initiation of TB preventive treatment (TPT) in Ghana. Design: Prospective cohort study from August 2019 to December 2020. Setting: One hospital from each of Ghana's regions (10 total). Participants: Any PLHIV already receiving or newly initiating antiretroviral treatment were eligible for inclusion. Interventions: All participants received TB symptom screening and chest radiography. Those with symptoms and/or an abnormal chest X-ray provided a sputum sample for microbiological testing. All without TB disease were offered TPT. Primary and Secondary Outcome Measures: We estimated the proportion diagnosed with TB disease and proportion initiating TPT. We used logistic regression to identify factors associated with TB disease diagnosis. We used microcosting to estimate the health system cost per person screened (2020 US$). Results: Of 12 916 PLHIV attending participating clinics, 2639 (20%) were enrolled in the study and screened for TB disease. Overall, 341/2639 (12.9%, 95% CI 11.7% to 14.3%) had TB symptoms and/or an abnormal chest X-ray; 50/2639 (1.9%; 95% CI 1.4% to 2.5%) were diagnosed with TB disease, 20% of which was subclinical. In multivariable analysis, only those newly initiating antiretroviral treatment were at increased odds of TB disease (adjusted OR 4.1, 95% CI 2.0 to 8.2). Among 2589 participants without TB, 2581/2589 (99.7%) initiated TPT. Overall, the average cost per person screened during the study was US$57.32. Conclusion: In Ghana, systematic TB disease screening among PLHIV was of high yield and modest cost when combined with TPT. Our findings support WHO recommendations for routine TB disease screening among PLHIV. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
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| معلومات مُعتمدة: | 001 International WHO_ World Health Organization |
| فهرسة مساهمة: | Keywords: Implementation Science; Mass Screening; Primary Prevention; Tuberculosis |
| المشرفين على المادة: | 0 (Anti-Retroviral Agents) |
| تواريخ الأحداث: | Date Created: 20240528 Date Completed: 20240528 Latest Revision: 20240607 |
| رمز التحديث: | 20240607 |
| مُعرف محوري في PubMed: | PMC11138302 |
| DOI: | 10.1136/bmjopen-2023-083557 |
| PMID: | 38806436 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2044-6055 |
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| DOI: | 10.1136/bmjopen-2023-083557 |