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Patient-led active tuberculosis case-finding in the Democratic Republic of the Congo
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Patient-led active tuberculosis case-finding in the Democratic Republic of the Congo
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Journal Article
Patient-led active tuberculosis case-finding in the Democratic Republic of the Congo
2018
Overview
To investigate the effect of using volunteer screeners in active tuberculosis case-finding in South Kivu, the Democratic Republic of the Congo, especially among groups at high risk of tuberculosis infection.
To identify and screen high-risk groups in remote communities, we trained volunteer screeners, mainly those who had themselves received treatment for tuberculosis or had a family history of the disease. A non-profit organization was created and screeners received training on the disease and its transmission at 3-day workshops. Screeners recorded the number of people screened, reporting a prolonged cough and who attended a clinic for testing, as well as test results. Data were evaluated every quarter during the 3-year period of the intervention (2014-2016).
Acceptability of the intervention was high. Volunteers screened 650 434 individuals in their communities, 73 418 of whom reported a prolonged cough; 50 368 subsequently attended a clinic for tuberculosis testing. Tuberculosis was diagnosed in 1 in 151 people screened, costing 0.29 United States dollars (US$) per person screened and US$ 44 per person diagnosed. Although members of high-risk groups with poorer access to health care represented only 5.1% (33 002/650 434) of those screened, they contributed 19.7% (845/4300) of tuberculosis diagnoses (1 diagnosis per 39 screened). The intervention resulted in an additional 4300 sputum-smear-positive pulmonary tuberculosis diagnoses, 42% (4 300/10 247) of the provincial total for that period.
Patient-led active tuberculosis case-finding represents a valuable complement to traditional case-finding, and should be used to assist health systems in the elimination of tuberculosis.
Publisher
World Health Organization
Subject
/ Antitubercular Agents - therapeutic use
/ Clinics
/ Community Health Services - methods
/ Costing
/ Cough
/ Democratic Republic of the Congo - epidemiology
/ Disease
/ Female
/ Genetics
/ HIV
/ Human immunodeficiency virus
/ Humans
/ Male
/ Mass Screening - organization & administration
/ Patients
/ Risk
/ Scandals
/ Smear
/ Sputum
/ Training
/ Tuberculosis, Pulmonary - diagnosis
/ Tuberculosis, Pulmonary - drug therapy
/ Tuberculosis, Pulmonary - epidemiology
