Population-based screening for pulmonary tuberculosis utilizing community health workers in Ethiopia
Population-based screening for pulmonary tuberculosis utilizing community health workers in Ethiopia
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在埃塞俄比亚利用社区卫生工作者进行基于人群的肺结核筛查
DOI：
10.1016/j.ijid.2019.10.012
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发表时间：
2019-12-01
影响因子：
8.4
通讯作者：
Aseffa, Abraham
中科院分区：
文献类型：
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作者：
Merid, Yared;Mulate, Yimtubezinash Woldeamanuel;Aseffa, Abraham
目的：评估效用的志愿者健康发展军队在进行人口筛查活动性结核病（TB）在农村社区在南部Ethiopia.Methods：一个以人口为基础的横断面调查进行了6个kebeles（最低的行政单位）。志愿妇女社区工作者领导了一项症状筛查方案，以查明社区中15岁以上的结核病患者。对咳嗽≥ 2周的个体进行现场和早晨痰样本采集，使用抗酸杆菌（AFB）涂片显微镜检查、培养和Xpert MTB/RIF进行检查。结果：研究区域的所有24 517名成年人都进行了症状筛查; 544人（2.2%）咳嗽≥ 2周。在症状筛查阳性的患者中，13例（2.4%）痰AFB涂片镜检阳性，13例（2.4%）培养阳性，32例（5.8%）Xpert MTB/RIF检测阳性。总体而言，通过培养和/或Xpert鉴定出34例结核病例（6%），相当于每10万人中有139例患病。这项研究证明了社区卫生工作者的能力（志愿者和付费）快速开展大规模人群结核病筛查评价，并强调该项目与Xpert MTB/RIF测试。这可以作为在其他类似环境中实施的模式。(C)2019年，任作家。由爱思唯尔有限公司代表国际传染病学会出版。
Objective: To evaluate the utility of a volunteer health development army in conducting population screening for active tuberculosis (TB) in a rural community in southern Ethiopia.Methods: A population-based cross-sectional survey was conducted in six kebeles (the lowest administrative units). Volunteer women community workers led a symptom screening programme to identify adults >= 15 years of age with TB in the community. Individuals with a cough for >= 2 weeks had spot and morning sputum samples taken, which were examined using acid-fast bacillus (AFB) smear microscopy, culture, and Xpert MTB/RIF.Results: All 24 517 adults in the study area had a symptom screen performed; 544 (2.2%) had had a cough for >= 2 weeks. Among those with a positive symptom screen, 13 (2.4%) were positive on sputum AFB smear microscopy, 13 (2.4%) had a positive culture, and 32 (5.8%) had a positive Xpert MTB/RIF test. Overall, 34 TB cases (6%) were identified by culture and/or Xpert, corresponding to a prevalence of 139 per 100 000 persons.Conclusions: This study demonstrated the capability of community health workers (volunteer and paid) to rapidly conduct a large-scale population TB screening evaluation and highlight the high yield of such a programme in detecting previously undiagnosed cases when combined with Xpert MTB/RIF testing. This could be a model to implement in other similar settings. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.