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Population-based Screening for Pulmonary Tuberculosis utilizing Community Health Workers in Ethiopia

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Merid, Yared, Mulate, Yimtubezinash Woldeamanuel, Hailu, Mesay, Hailu, Tsegaye, Habtamu, Getnet, Abebe, Markos, Datiko, Daniel and Aseffa, Abraham (2019) 'Population-based Screening for Pulmonary Tuberculosis utilizing Community Health Workers in Ethiopia'. International Journal of Infectious Diseases, Vol 89, pp. 122-127.

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Abstract

Objective
To evaluate the utility of a volunteer health development army in conducting population screening for active TB in a rural community in Southern Ethiopia.

Methods
A population-based cross-sectional survey was conducted in sixKebeles (the lowest administrative units).Volunteer women community workers led a symptom screening program to identify adults ≥15 years with TB in the community. Individuals with cough ≥ 2 weeks had spot and morning sputum samples and were examined using AFB smear microscopy, culture and Xpert MTB/RIF.

Results
All 24,517 adults in the study area had a symptom screen performed; 544 (2.2%) had cough ≥ 2 weeks. Among a positive symptom screen, 13 (2.4%) had a positive sputum AFB smear microscopy, 13 (2.4%) a positive culture and 32 (5.8%) a positive Xpert MTB/RIF test. Overall, 34 TB cases (6%) were identified by culture and/or Xpert which corresponds to a prevalence of 139 per 100,000 persons.

Conclusion
We demonstrate the capability of community health workers (volunteer and paid) to rapidly conduct a large-scale population TB screening evaluation and highlight the high yield of such a program to detect previously undiagnosed cases when combined with Xpert MTB/RIF testing. This could be a model to implement in other similar settings.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
WF Respiratory System > Tuberculosis > WF 300 Pulmonary tuberculosis
Digital Object Identifer (DOI): https://doi.org/10.1016/j.ijid.2019.10.012
Depositing User: Stacy Murtagh
Date Deposited: 28 Oct 2019 15:48
Last Modified: 20 Nov 2019 15:23
URI: https://archive.lstmed.ac.uk/id/eprint/12918

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