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Journal Article
|Research

Mobile community-based active case-finding for tuberculosis among older populations in rural Cambodia

Camelique O, Scholtissen S, Dousset JP, Bonnet MMB, Bastard M, Hewison CCH
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Abstract
OBJECTIVE
To systematically screen older rural populations in Cambodia for tuberculosis (TB) and develop an effective active case-finding (ACF) model for this TB high-risk group.

DESIGN
A retrospective study using routinely collected programmatic data on community-based ACF among people aged ≥55 years using TB symptoms and systematic chest radiography (CXR) screening, followed by Xpert® MTB/RIF testing for participants with positive screening results and TB culture for certain Xpert-negative specimens.

RESULTS
Of 22 101 participants included in the analysis, 7469 (33.8%) were screening-positive and 5960 (27.0%) underwent Xpert testing. Pulmonary TB was identified in 482 (2.2%) individuals: 288 (1.3%) were bacteriologically confirmed (253 using Xpert, 35 using culture) and 194 (0.9%) were clinically diagnosed. Eighty-seven people needed to be screened in order to diagnose one Xpert-positive case. Among the Xpert-positive cases, only 31.6% (80/253) reported cough ≥2 weeks, and 39.9% (101/253) were asymptomatic but had a CXR suggestive of active TB. Treatment uptake was 97.3% (469/482), and treatment success was 88.0% (424/482).

CONCLUSIONS
Community-based ACF was effective in detecting and successfully treating older TB patients, most of whom might otherwise have remained undiagnosed. Mobile CXR appears to be crucial in identifying a high number of asymptomatic, bacteriologically confirmed cases.

Countries

Cambodia

Subject Area

tuberculosisdiagnosticsmodels of care

Languages

English
DOI
10.5588/ijtld.18.0611
Published Date
01 Oct 2019
PubMed ID
31627776
Journal
International Journal of Tuberculosis and Lung Disease
Volume | Issue | Pages
Volume 23, Issue 10, Pages 1107-1114
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Mobile community-based active case-finding for tuberculosis among older populations in rural Cambodia | Journal Article / Research | MSF Science Portal