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OA-31-690-23 Methods and challenges of National TB Prevalence Surveys in Asia and sub-Saharan Africa: a systematic review

Mishra, G, Sharma, SK, Caws, Maxine ORCID: and Wingfield, Tom ORCID: (2020) 'OA-31-690-23 Methods and challenges of National TB Prevalence Surveys in Asia and sub-Saharan Africa: a systematic review' in THE 51ST UNION WORLD CONFERENCE ON LUNG HEALTH, Online, 20-24th October 2020.

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Background and challenges to implementation: Nation- al TB Prevalence Surveys (TBPS) provide valuable in- formation to policy makers and National TB Programs about TB burden and missing cases. However, TBPS can be challenging, especially in TB-endemic low- and middle-income countries (LMICs).
Intervention or response: We reviewed 28 World Health Organisation (WHO) TBPS reports from Asia (n=14) and sub-Saharan Africa (n=14), published after 2000. All surveys were population based and followed WHO guidance. All surveys used a TB symptom screening questionnaire and chest radiograph to identify people with suspected TB disease. Acid Fast Bacilli (AFB) smear (25/28, 89%), fluorescence microscopy (17/28, 61%), and mycobacterial culture (27/28, 96%) were used to diagnosed TB, with most post-2010 surveys also using GeneXpert (14/28, 50%).
Results/Impact: Several domains of TBPS challenges were identified and are summarized in Table 1. They included:
1) under-recruitment in urban settings (4/28, 14%) and exclusion of children and people with extrapulmonary or clinically-diagnosed TB (28/28, 100%); 2) under-representation of risk groups due to lack of complementary data collection concerning social deter- minants and reliance on self-reporting of TB risk factors including HIV and diabetes (28/28, 100%);
3) diagnostic limitations including reliance on low-sen- sitivity smear testing (14/28, 50%) and impaired labora- tory capacity;
4) logistical implementation constraints including lack of funding and security issues; and,
5) issues with data management, especially with paper- based data collection (4/28, 14%).
Conclusions: Asian and African LMICs planning to con- duct TBPS should focus on addressing potential modi- fiable challenges including: garnering adequate fund- ing and promoting a sustainable workforce; developing context- and resource-specific diagnostic algorithms to improve TB yield; social mobilization and awareness campaigns to improve participation, including of hard- to-reach groups; expanding inclusion criteria to children and non-microbiologically confirmed TB cases; better linkage with socioeconomic and health data; and paper- less data collection and management tools.

Item Type: Conference or Workshop Item (Speech)
Additional Information: Abstract Only: Published in The International Journal of Tuberculosis and Lung Disease, 'The Abstract Book', Vol 24 No 10 October 2020 Supplement 2
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 540 National and state health administration
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Related URLs:
Depositing User: Marie Hatton
Date Deposited: 06 Nov 2020 16:28
Last Modified: 11 Nov 2020 12:33


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