Are patients with pulmonary tuberculosis identified by active and by passive case detection different? A cross-sectional study in Pakistan
•Comparison in characteristics of tuberculosis (TB) patients by case finding strategies in Pakistan.•Extended contact screening detected a higher proportion of men and children.•Active case finding is as an important addition to routine TB control. Our objective was to compare the characteristics of...
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| Published in | International journal of infectious diseases Vol. 121; pp. 39 - 46 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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Canada
Elsevier Ltd
01.08.2022
Elsevier |
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| Abstract | •Comparison in characteristics of tuberculosis (TB) patients by case finding strategies in Pakistan.•Extended contact screening detected a higher proportion of men and children.•Active case finding is as an important addition to routine TB control.
Our objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through “extended contact screening” (ECS) with those of patients identified through routine passive case finding (PCF).
Active TB case finding by ECS was tested from 2013–2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared.
Of the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8–57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6–50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1–88.9) in the ECS group and 50.3% (95% CI 49.2–51.4) in the PCF group. By regression analysis we found that compared with patients aged 15–44 years, children aged <15 years had higher chances of being identified through ECS (adjusted odds ratio 2.69; 95% CI 2.21–3.28). There was a higher chance of cases being detected by ECS in Faisalabad (adjusted odds ratio 2.57; 95% CI 2.01–3.29) than in Islamabad.
ECS identified a higher proportion of male and child patients with pulmonary TB than routine case finding; both of these groups are more often unidentified through routine TB control. |
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| AbstractList | Our objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through "extended contact screening" (ECS) with those of patients identified through routine passive case finding (PCF).OBJECTIVESOur objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through "extended contact screening" (ECS) with those of patients identified through routine passive case finding (PCF).Active TB case finding by ECS was tested from 2013-2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared.METHODSActive TB case finding by ECS was tested from 2013-2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared.Of the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8-57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6-50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1-88.9) in the ECS group and 50.3% (95% CI 49.2-51.4) in the PCF group. By regression analysis we found that compared with patients aged 15-44 years, children aged <15 years had higher chances of being identified through ECS (adjusted odds ratio 2.69; 95% CI 2.21-3.28). There was a higher chance of cases being detected by ECS in Faisalabad (adjusted odds ratio 2.57; 95% CI 2.01-3.29) than in Islamabad.RESULTSOf the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8-57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6-50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1-88.9) in the ECS group and 50.3% (95% CI 49.2-51.4) in the PCF group. By regression analysis we found that compared with patients aged 15-44 years, children aged <15 years had higher chances of being identified through ECS (adjusted odds ratio 2.69; 95% CI 2.21-3.28). There was a higher chance of cases being detected by ECS in Faisalabad (adjusted odds ratio 2.57; 95% CI 2.01-3.29) than in Islamabad.ECS identified a higher proportion of male and child patients with pulmonary TB than routine case finding; both of these groups are more often unidentified through routine TB control.CONCLUSIONECS identified a higher proportion of male and child patients with pulmonary TB than routine case finding; both of these groups are more often unidentified through routine TB control. •Comparison in characteristics of tuberculosis (TB) patients by case finding strategies in Pakistan.•Extended contact screening detected a higher proportion of men and children.•Active case finding is as an important addition to routine TB control. Our objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through “extended contact screening” (ECS) with those of patients identified through routine passive case finding (PCF). Active TB case finding by ECS was tested from 2013–2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared. Of the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8–57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6–50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1–88.9) in the ECS group and 50.3% (95% CI 49.2–51.4) in the PCF group. By regression analysis we found that compared with patients aged 15–44 years, children aged <15 years had higher chances of being identified through ECS (adjusted odds ratio 2.69; 95% CI 2.21–3.28). There was a higher chance of cases being detected by ECS in Faisalabad (adjusted odds ratio 2.57; 95% CI 2.01–3.29) than in Islamabad. ECS identified a higher proportion of male and child patients with pulmonary TB than routine case finding; both of these groups are more often unidentified through routine TB control. Our objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through "extended contact screening" (ECS) with those of patients identified through routine passive case finding (PCF). Active TB case finding by ECS was tested from 2013-2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared. Of the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8-57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6-50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1-88.9) in the ECS group and 50.3% (95% CI 49.2-51.4) in the PCF group. By regression analysis we found that compared with patients aged 15-44 years, children aged <15 years had higher chances of being identified through ECS (adjusted odds ratio 2.69; 95% CI 2.21-3.28). There was a higher chance of cases being detected by ECS in Faisalabad (adjusted odds ratio 2.57; 95% CI 2.01-3.29) than in Islamabad. ECS identified a higher proportion of male and child patients with pulmonary TB than routine case finding; both of these groups are more often unidentified through routine TB control. Objectives: Our objective was to compare the characteristics of patients with pulmonary tuberculosis (TB) identified through “extended contact screening” (ECS) with those of patients identified through routine passive case finding (PCF). Methods: Active TB case finding by ECS was tested from 2013–2015. This was a cross-sectional study based on data collected from ECS and routine program data from Lahore, Faisalabad, and Rawalpindi districts, and Islamabad in 2015. Characteristics of patients identified through ECS and PCF were compared. Results: Of the 12,114 patients with pulmonary TB in the study, 4604 (38%) were identified through ECS, of whom 4052 (88%) had bacteriological confirmation. Male patients comprised 56.2% (95% confidence interval [CI] 54.8–57.6) of patients with pulmonary TB identified through ECS and 49.7% (95% CI 48.6–50.8) of those identified through PCF. The proportion of bacteriologically confirmed cases was 88.0% (95% CI 87.1–88.9) in the ECS group and 50.3% (95% CI 49.2–51.4) in the PCF group. By regression analysis we found that compared with patients aged 15–44 years, children aged <15 years had higher chances of being identified through ECS (adjusted odds ratio 2.69; 95% CI 2.21–3.28). There was a higher chance of cases being detected by ECS in Faisalabad (adjusted odds ratio 2.57; 95% CI 2.01–3.29) than in Islamabad. Conclusion: ECS identified a higher proportion of male and child patients with pulmonary TB than routine case finding; both of these groups are more often unidentified through routine TB control. |
| Author | Hinderaker, Sven G. Qadeer, Ejaz Haq, Mahboob Ul Khan, Abdul Wali Habib, Hammad Hussain, Kashif Fatima, Razia |
| Author_xml | – sequence: 1 givenname: Mahboob Ul orcidid: 0000-0002-3709-3496 surname: Haq fullname: Haq, Mahboob Ul email: mahboob0345@yahoo.com organization: University of Bergen, Norway – sequence: 2 givenname: Sven G. surname: Hinderaker fullname: Hinderaker, Sven G. organization: University of Bergen, Norway – sequence: 3 givenname: Razia orcidid: 0000-0002-2340-6121 surname: Fatima fullname: Fatima, Razia organization: Common Management Unit for AIDS, TB & Malaria, Islamabad, Pakistan – sequence: 4 givenname: Ejaz surname: Qadeer fullname: Qadeer, Ejaz organization: Pakistan Institute of Medical Sciences, Islamabad, Pakistan – sequence: 5 givenname: Hammad surname: Habib fullname: Habib, Hammad organization: Common Management Unit for AIDS, TB & Malaria, Islamabad, Pakistan – sequence: 6 givenname: Kashif surname: Hussain fullname: Hussain, Kashif organization: Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan – sequence: 7 givenname: Abdul Wali surname: Khan fullname: Khan, Abdul Wali organization: Common Management Unit for AIDS, TB & Malaria, Islamabad, Pakistan |
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| Cites_doi | 10.1186/1471-2458-12-469 10.5588/ijtld.20.0129 10.4269/ajtmh.2011.10-0701 10.1016/j.ijid.2021.01.054 10.1371/journal.pmed.1002119 10.1016/S2214-109X(18)30520-5 10.5588/ijtld.18.0449 10.1056/NEJMoa1700209 10.1111/tmi.12534 10.1186/s12913-019-4444-z 10.1371/journal.pone.0213345 10.1016/S0035-9203(99)90128-1 10.1016/j.ijid.2018.02.012 10.1177/003335490512000309 10.1371/journal.pone.0237931 10.1371/journal.pone.0148293 10.2147/CEOR.S92244 10.1371/journal.pone.0165813 10.1371/journal.pone.0146392 10.1016/S0140-6736(19)30024-8 10.1016/S0041-3879(82)80028-7 |
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| Keywords | Extended contact screening Pulmonary tuberculosis Passive case finding |
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| Title | Are patients with pulmonary tuberculosis identified by active and by passive case detection different? A cross-sectional study in Pakistan |
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