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Increasing Detection and Confirmation of Tuberculosis in Children in Southern Ethiopia: Pooled Samples Tested Using Microscopy and Xpert

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Journal of Tuberculosis Research 2018年第3期6卷 215-226页

作者： daniel G. datiko Mulualem A. Gadena Mubarek A. Yassin Kefyalew T. Garie Moges D. Ormago Luis E. Cuevas REACH Ethiopia Hawassa Ethiopia University of Hawassa Hawassa Ethiopia Liverpool School of Tropical Medicine Pembroke Place Liverpool UK

Background: Childhood tuberculosis accounts for about 10% of estimated TB cases in the world. Despite advances in diagnostics, childhood TB remains a challenge. We evaluated pooling method and testing with GeneXpert MTB/RIF in southern Ethiopia. Methods: This is a cross-sectional study in presumptive TB children st, 2nd and pooled samples. Results: Of 340 presumptive TB cases enrolled, 96 and 244 children submitted gastric aspirate and sputum samples respectively. Of 1020 samples collected (282 gastric aspirate and 738 sputum samples), 38 (3.7%) were positive by Xpert (10 (3.5%) from gastric aspirate and 28 (3.8%) from sputum sample). Similarly, 8 (1.2%) of sputum samples were positive by ZN but none from gastric aspirate. Of 244 children who submitted sputum samples, 3 (1.2%) were bacteriologically positive compared to 12 (4.9%) by Xpert. Of 96 children who submitted gastric aspirate samples, none were positive by ZN while 5 (5.2%) were positive by Xpert. Of bacteriologically confirmed TB cases 0.9% was by ZN and 4.7% by Xpert, an increase of 3.8%. Pooled testing increased positivity by 0.3% for ZN and 1.5% by Xpert compared to the 1st sample. Conclusions: Xpert MTB/RIF testing increases yield compared to ZN testing for gastric aspirate samples. The same-day approach and pooling samples improves efficient use of cartridge, reduce the number of visits for seeking diagnosis and save resources.

关键词： TB Children GeneXpert MTB/RIF Pooled Sample

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Patients direct costs to undergo TB diagnosis

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Infectious Diseases of Poverty 2016年第1期5卷 221-229页

作者： Rachel M.Anderson de Cuevas Lovett Lawson Najla Al-Sonboli Nasher Al-Aghbari Isabel Arbide Jeevan B.Sherchand Emenyonu E.Nnamdi Abraham Aseffa Mohammed A.Yassin Saddiq T.Abdurrahman Joshua Obasanya Oladimeji Olanrewaju daniel datiko Sally J.Theobald Andrew Ramsay S.Bertel Squire Luis E.Cuevas Liverpool School of Tropical Medicine Pembroke PlaceLiverpool L35QAUK Zankli Medical Center AbujaNigeria Bingham University Nassarawa StateAbujaNigeria Medical Faculty Sana’a UniversitySana’aYemen National Tuberculosis Institute Sana’aYemen Bushullo Major Health Centre AwassaEthiopia Tribhuvan University Institute of Medicine KathmanduNepal Armauer Hansen Research Institute Addis AbabaEthiopia The Global Fund to Fight AIDS Tuberculosis and MalariaGenevaSwitzerland Federal Capital Territory Tuberculosis and Leprosy Control Programme AbujaNigeria Nigeria Tuberculosis and Leprosy Control Programme AbujaNigeria REACH Ethiopia HawassaEthiopia UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases World Health OrganizationGenevaSwitzerland

Background:A major impediment to the treatment of TB is a diagnostic process that requires multiple *** of patient costs associated with diagnosis use different protocols and are not ***:We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for *** of 2225 adults attending smear-microscopy centres in Nigeria,Nepal,Ethiopia and ***>18 years with cough>2 weeks were enrolled *** costs were quantified using structured *** with costs>75^(th) quartile were considered to have high expenditure(cases)and compared with patients with costs<75^(th) quartile to identify factors associated with high ***:The most significant expenses were due to clinic fees and *** participants attended the centres with *** expenditure was associated with attending with company,residing in rural areas/other towns and ***:The costs incurred by patients are substantial and share common patterns across *** user fees,transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic *** locations with limited resources,support could be prioritised for those most at risk of high expenditure;those who are illiterate,attend the service with company and rural residents.

关键词： Tuberculosis Costs Access to healthcare Ethiopia Nepal Nigeria Yemen

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