Feasibility of a streamlined tuberculosis diagnosis and treatment initiation strategy

نویسندگان

  • P. B. Shete
  • T. Nalugwa
  • K. Farr
  • C. Ojok
  • M. Nantale
  • P. Howlett
  • P. Haguma
  • E. Ochom
  • F. Mugabe
  • M. Joloba
  • L. H. Chaisson
  • D. W. Dowdy
  • D. Moore
  • J. L. Davis
  • A. Katamba
  • A. Cattamanchi
چکیده

OBJECTIVE To assess the feasibility of a streamlined strategy for improving tuberculosis (TB) diagnostic evaluation and treatment initiation among patients with presumed TB. DESIGN Single-arm interventional pilot study at five primary care health centers of a streamlined, SIngle-saMPLE (SIMPLE) TB diagnostic evaluation strategy: 1) examination of two smear results from a single spot sputum specimen using light-emitting diode fluorescence microscopy, and 2) daily transportation of smear-negative sputum samples to Xpert® MTB/RIF testing sites. RESULTS Of 1212 adults who underwent sputum testing for TB, 99.6% had two smears examined from the spot sputum specimen. Sputum was transported for Xpert testing within 1 clinic day for 83% (907/1091) of the smear-negative patients. Of 157 (13%) patients with bacteriologically positive TB, 116 (74%) were identified using sputum smear microscopy and 41 (26%) using Xpert testing of smear-negative samples. Anti-tuberculosis treatment was initiated in 142 (90%) patients with bacteriologically positive TB, with a median time to treatment of 1 day for smear-positive patients and 6 days for smear-negative, Xpert-positive patients. CONCLUSION The SIMPLE TB strategy led to successful incorporation of Xpert testing and rapid treatment initiation in the majority of patients with bacteriologically confirmed TB in a resource-limited setting.

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عنوان ژورنال:

دوره 21  شماره 

صفحات  -

تاریخ انتشار 2017