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Assessing the Effectiveness of Xpert MTB/RIF in the Diagnoses of TB Among HIV Smear Negative TB Patients in Nigeria

Journal of Health Science 2014年第3期2卷 145-151页

作者： Mustapha Gidado olajumoke onazi Olusegun Obasanya Nkem Chukwuem Moses onazi Amos Omoniyi Temitayo Odusote KNCV Tuberculosis Foundation/TB CARE I Project Abuja 23464 Federal Capital Territory Nigeria National Tuberculosis and Leprosy Control Abuja 23464 Federal Capital Territory Nigeria Research and Data Solutions Abuja 23464 Federal Capital Territory Nigeria World Health Organization/TB CARE I Project Abuja 23464 Federal Capital Territory Nigeria United State Agency for International Development TB/HIV Team Abuja 23464 Federal Capital Territory Nigeria

Through KNCV/TB CARE 1 Project, the first set of 9 Xpert MTB/RIF machines were installed in Nigeria in 2011 with additional 6 machines in 2012 for improved diagnosis of TB and DR-TB in the country. The study assessed the performance of the Xpert MTB/RIF machines over the period of 2011-2012 in various locations and its impact on TB diagnosis among PLHIV （people living with HIV）. A total of 3,725 sputa samples were tested by Xpert MTB/RIF machines. Of these, a total of 463 （12.4%） sputa samples were from PLHIV AFB smears negative suspects. Three hundred and fifty seven （77.0%） sputa samples tested MTB negative, 78 （17.0%） tested MTB positive while 28 （6.0%） samples had error results. This indicated an additional diagnostic yield of about 17.0% over AFB test. Of those that were MTB positives, 5 （6.4%） had resistance to rifampicin. The study shows the need to expand Xpert MTB/RIF services to ART centres as well as to other states of the country to aid early detection and diagnosis of TB in PLHIV patients and MTB Rifampicin resistance cases as well as prevent transmission or resistance strains of YB.

关键词： PLHIV Xpert MTB/RIF tuberculosis smear negatives.

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Factors Undermining the Investigation of Child Contacts of TB Patients： The Case of FCT, Abuja, Nigeria

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Journal of Health Science 2014年第3期2卷 152-156页

作者： olajumoke onazi Saddiq Abdurrahman Emmy Van der Grinten Moses onazi Enang Oyama Mustapha Gidado Amos Fadare Omoniyi TBCARE I Project M&E Unit Federal Capital Territory Abuja 930283 Nigeria Federal Capital Territory TB and Leprosy Control Program Federal Capital Territory Abuja 930283 Nigeria American Leprosy Missions Aburi M169 Ghana Research and Data Solutions Federal Capital Territory Abuja 930283 Nigeria WHO Office Abuja 930283 Nigeria

Facility records of 320 TB （tuberculosis） patients were examined over a one-year-period; January-December 2009 to ascertain the screening of children under 6 years of age who have had contacts with sputum smear positive TB patients as stipulated in the NTBLCP （National Tuberculosis and Leprosy Control Program） guidelines. In addition, semi-structured questionnaires were administered to 28 DOTS （directly-observed treatment strategy） clinicians to elicit information to help explain findings from the analysis of the routine data. Over 60% of children less than 6 years of age who had contacts with TB patients were not investigated in the health facilities included in the survey. The level of educational attainment of DOTS providers was associated with the screening of TB patients＇ contacts （P = 0.008）. Forgetfulness by clinicians to ask for or screen children of TB patients in the facilities is the singular most important factor undermining contact investigation. The proportion of under 6 years TB contacts screened or not screened for TB in the facilities was similar according to the age and gender of TB patients, and the type of health facilities where treatment was accessed by patients （P = 0.325）. The study underscored the need for the state program to evaluate the quality of service provision as well as counseling provided to TB patients at the facilities.

关键词： Contact investigation children contact tuberculosis TB patients case finding.

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