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Increasing smear po...
Increasing smear positive tuberculosis detection using a clinical score - A stepped wedge multicenter trial from Africa
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- Rudolf, Frauke (author)
- Bandim Hlth Project, Guinea Bissau; Aarhus Univ Hosp, Denmark
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- Abate, Ebba (author)
- Ethiopian Publ Hlth Inst EPHI, Ethiopia
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- Moges, Binyam (author)
- Univ Gondar, Ethiopia
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- Mendes, Antonio Mateus (author)
- Bandim Hlth Project, Guinea Bissau
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- Mengistu, Mezgebu Yitayal (author)
- Univ Gondar, Ethiopia
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- Sifna, Armando (author)
- Bandim Hlth Project, Guinea Bissau
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- Fekadu, Hikma (author)
- Univ Gondar, Ethiopia
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- Bizuneh, Segenet (author)
- Univ Gondar, Ethiopia
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- Schön, Thomas, 1973- (author)
- Linköpings universitet,Avdelningen för inflammation och infektion,Medicinska fakulteten,Region Östergötland, Infektionskliniken i Östergötland,Kalmar Cty Hosp, Sweden
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- Wejse, Christian (author)
- Bandim Hlth Project, Guinea Bissau; Aarhus Univ Hosp, Denmark; Aarhus Univ, Denmark
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(creator_code:org_t)
- Elsevier Science Ltd, 2021
- 2021
- English.
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In: International Journal of Infectious Diseases. - : Elsevier Science Ltd. - 1201-9712 .- 1878-3511. ; 113, s. S55-S62
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Abstract
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- Background: The Bandim TBscore is a clinical score that predicts treatment outcome in Tuberculosis (TB) patients and proved useful as an indicator of which healthcare-seeking adults to refer for sputum smear microcopy. We aimed to test in a randomized trial if the TBscore could be used to enhance the detection of smear positive (SP) TB. Methods: We carried out a stepped wedge cluster-randomized trial at six health centers in Bissau, GuineaBissau, and Gondar, Ethiopia. The primary outcome was diagnostic yield for SP TB. Secondary outcomes were successful treatment and effect on overall 12 months mortality. The study was registered at the Pan African Clinical Trials Registry (PACTR201611001838365). Results: We included 3571 adults. Overall, there was no effect of the intervention on SP PTB detected (OR 1.39 (95%CI 0.75 - 2.56). Analysis stratified by country, showed that the TBscore increased case detection in Gondar (OR 4.05 (95%CI 1.67 - 9.85)) but no effect was found in Bissau (OR 0.47 (95%CI 0.22 - 1.05)) where take-up was much lower. Overall mortality decreased during the intervention (HR 0.31 (95%CI 0.13-0.72)). Conclusion: Using the TBscore for triage before smear microscopy may improve case detection and decrease mortality if there is sufficient laboratory capacity to increase sputum smears. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- Tuberculosis; Case detection; Stepped wedge; TB score
Publication and Content Type
- ref (subject category)
- art (subject category)
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Rudolf, Frauke
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Abate, Ebba
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Moges, Binyam
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Mendes, Antonio ...
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Mengistu, Mezgeb ...
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Sifna, Armando
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Fekadu, Hikma
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Bizuneh, Segenet
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Schön, Thomas, 1 ...
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Wejse, Christian
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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Linköping University