Can Intensified Tuberculosis Case Finding Efforts at Nutrition Rehabilitation Centers Lead to Pediatric Case Detection in Bihar, India?

Rajeev R Pathak, Bal Krishna Mishra, Patrick K Moonan, Sreenivas A Nair, Ajay M V Kumar, Mohit P Gandhi, Shamim Mannan, Smita Ghosh
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引用次数: 13

Abstract

Introduction Seven district-level Nutritional Rehabilitation Centres (NRCs) in Bihar, India provide clinical and nutritional care for children with severe acute malnutrition (SAM). Aim To assess whether intensified case finding (ICF) strategies at NRCs can lead to pediatric case detection among SAM children and link them to TB treatment under the Revised National Tuberculosis Control Programme (RNTCP). Materials and Methods A retrospective cohort study was conducted that included medical record reviews of SAM children registered for TB screening and RNTCP care during July–December 2012. Results Among 440 SAM children screened, 39 (8.8%) were diagnosed with TB. Among these, 34 (87%) initiated TB treatment and 18 (53%) were registered with the RNTCP. Of 16 children not registered under the RNTCP, nine (56%) weighed below six kilograms—the current weight requirement for receiving drugs under RNTCP. Conclusion ICF approaches are feasible at NRCs; however, screening for TB entails diagnostic challenges, especially among SAM children. However, only half of the children diagnosed with TB were treated by the RNTCP. More effort is needed to link this vulnerable population to TB services in addition to introducing child-friendly drug formulations for covering children weighing less than six kilograms.

Abstract Image

在印度比哈尔邦,营养康复中心加强肺结核病例发现工作能否导致小儿病例发现?
简介:印度比哈尔邦的七个区级营养康复中心(nrc)为患有严重急性营养不良(SAM)的儿童提供临床和营养护理。目的:评估nrc的强化病例发现(ICF)策略是否可以导致SAM儿童的儿科病例发现,并将其与修订的国家结核病控制规划(RNTCP)下的结核病治疗联系起来。材料和方法:进行了一项回顾性队列研究,包括对2012年7月至12月登记进行结核病筛查和RNTCP治疗的SAM儿童的医疗记录进行审查。结果:在440名筛查的SAM儿童中,39名(8.8%)被诊断为结核病。其中34例(87%)开始了结核病治疗,18例(53%)在RNTCP登记。在16名未在RNTCP下注册的儿童中,有9名(56%)体重低于6公斤,这是目前RNTCP下接受药物的体重要求。结论:ICF治疗NRCs是可行的;然而,结核病筛查带来了诊断挑战,特别是在SAM儿童中。然而,只有一半被诊断患有结核病的儿童接受了RNTCP的治疗。除了引入适用于体重不足6公斤儿童的儿童友好型药物配方外,还需要作出更多努力,将这一弱势群体与结核病服务联系起来。
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