Improving childhood tuberculosis detection and treatment through facility-based screening in rural Pakistan
OBJECTIVE: To show the impact of systematic verbal screening and contact tracing with appropriate management services on TB case finding in pediatric populations.
DESIGN: Between October 2014 and March 2016, children were verbally screened at the pediatric out-patient departments of four public hospitals in Jamshoro District, Pakistan. Children with symptoms or risk of TB were referred for clinical evaluation and free chest X-ray and bacteriological tests. Children with TB were started on treatment and their care givers asked to bring household members to the hospital for screening.
RESULTS: Over 105 000 children were verbally screened and 5880 presumptive childhood TB patients were identified; 1417 children (prevalence 1.3%) were diagnosed with TB; 43% were female. The median age was 5 years; 82% had pulmonary TB. An additional 390 children with TB were diagnosed through contact tracing. These activities resulted in a three-fold increase in pediatric TB case notifications.
CONCLUSION: Systematic verbal screening with clinical evaluation and free diagnostics can identify children with TB who may otherwise be missed in rural health settings.
Document Type: Research Article
Affiliations: 1: Global Health Directorate, Indus Health Network, Interactive Research and Development, Pakistan, Emory University Rollins School of Public Health, Atlanta, Georgia, USA 2: Global Health Directorate, Indus Health Network, Interactive Research and Development, Pakistan 3: Stop TB Partnership 4: Global Health Directorate, Indus Health Network 5: Provincial TB Control Program, Karachi, Sindh, Pakistan 6: Interactive Research and Development, Pakistan
Publication date: August 1, 2018
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