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Free Content Intervention to increase detection of childhood tuberculosis in Bangladesh

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BACKGROUND: Despite a well-functioning adult tuberculosis (TB) control programme, children with TB remain grossly under-detected in Bangladesh. It is conservatively estimated that annually around 21 000 children with TB go undetected, due to an almost exclusive focus on sputum smear-positive TB and the absence of training or guidelines in paediatric TB.

OBJECTIVE: To double child TB detection by increasing general awareness and training of health care workers at microscopy centres supported by the Damien Foundation (DF) Bangladesh.

METHODS: A cluster-randomised trial was carried out with provision of child TB guidelines, training and logistics support to staff of 18 microscopy centres, while 18 non-adjacent microscopy centres continued their usual practice and served as controls. Paediatric data on TB suspect referral and case detection were collected at baseline and during the intervention at both control and intervention sites.

RESULTS: Child TB case detection increased in both intervention and control microscopy centres, but the increase was three times the baseline in the intervention centres (from 3.8% to 12%) in comparison to less than double the baseline in the control centres (from 4.3% to 7%, P = 0.001).

CONCLUSION: Simple guidelines and training on child TB case detection, together with basic logistics support, can be integrated into the existing National TB Control Programme and improve service delivery to children in TB-endemic areas.
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Keywords: Bangladesh; children; diagnosis; prevention; tuberculosis

Document Type: Research Article

Affiliations: 1: Centre for Woman and Child Health, Savar, Dhaka, Bangladesh 2: KNCV, The Hague, The Netherlands 3: The Children's Hospital at Westmead, Sidney, New South Wales, Australia; and Sydney Emerging Infectious Diseases and Biosecurity Institute (SEIB), University of Sydney, Sydney, New South Wales, Australia 4: Damien Foundation Bangladesh, Dhaka, Bangladesh 5: World Health Organization Bangladesh, Dhaka, Bangladesh

Publication date: 2012-01-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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