The Presence of Cough and Tuberculosis: Active Case Finding Outcomes in the Philippines

SiWon Lee, L. Lau, K. Lim, Jansel Ferma, Warren Dodd, D. Cole
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引用次数: 8

Abstract

The results of a tuberculosis (TB) active case finding (ACF) program, implemented by International Care Ministries (ICM) in the Philippines, were examined to understand how the presence of physical symptoms might influence ACF outcomes among extreme low-income Filipinos. ICM health staff implemented symptom screening in villages and suspected cases were referred to the closest rural health unit (RHU) for TB testing. ACF was carried out in Mindanao and the Visayas, across 16 different provinces. All participants were interviewed pre/postprogram, and screening outcomes were collected. A multilevel regression model was constructed to explore the effect of factors on the likelihood of getting tested. A total of 4635 individuals were screened; 1290 (27.8%) were symptom positive and referred. From those referred, 336 (7.2%) were tested for TB and 53 (1.1%) were TB positive. “Cough for more than two weeks” was associated with a 1.09 (95% CI 1.01, 1.15) times increase in likelihood of getting tested. The finding that the presence of cough is associated with higher rate of testing suggests that individuals in these settings might not know or believe that the lack of cough does not equate to lack of TB infection. While technologies and screening algorithms give us the ability to refine the ‘supply' side of the TB screening, addressing the knowledge gap should improve ‘demand'.
咳嗽和肺结核的存在:菲律宾的活跃病例发现结果
研究了菲律宾国际护理部(ICM)实施的肺结核主动病例发现(ACF)计划的结果,以了解身体症状的存在如何影响极端低收入菲律宾人的ACF结果。ICM卫生工作人员在村庄进行了症状筛查,疑似病例被转诊到最近的农村卫生单位进行结核病检测。ACF在棉兰老岛和维萨亚斯岛进行,分布在16个不同的省份。所有参与者在术前/术后接受访谈,并收集筛查结果。构建了一个多水平回归模型,以探讨因素对接受测试可能性的影响。共筛查了4635人;1290例(27.8%)为症状阳性并转诊。在被转诊的患者中,336人(7.2%)接受了结核病检测,53人(1.1%)呈结核病阳性。“咳嗽超过两周”与接受检测的可能性增加1.09倍(95%CI 1.01,1.15)有关。咳嗽与较高的检测率有关的发现表明,在这些环境中的个人可能不知道或不相信没有咳嗽并不等于没有结核病感染。虽然技术和筛查算法使我们能够完善结核病筛查的“供应”方面,但解决知识差距应该会改善“需求”。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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6
审稿时长
17 weeks
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