Improving sputum collection processes to increase tuberculosis case finding among HIV-positive persons in Botswana
Improving sputum collection processes to increase tuberculosis case finding among HIV-positive persons in Botswana
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DOI：
10.5588/pha.19.0051
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发表时间：
2020-03-21
影响因子：
1.4
通讯作者：
Finlay, A.
中科院分区：
文献类型：
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作者：
Mathebula, U.;Emerson, C.;Finlay, A.
研究地点：博茨瓦纳的22家人类免疫缺陷病毒(HIV)诊所。目的：比较现场工作改善初诊HIV感染者出现结核病症状前后的痰标本采集率、痰液质量和数量以及结核病诊断率。设计：从2012年8月至2014年3月，对在博茨瓦纳22家HIV诊所就诊的初诊HIV感染者进行结核病筛查。从2013年5月开始，实施现场干预，包括对推定结核病患者引入跟踪日志，并对患者进行指导和诱导，以提高吸痰率。结果：干预前，吸痰率为44.1%(384/870)。随后，痰收集增加到58.3%(579/993)(P<；0.001)。痰的质量和数量也有所改善。结核病诊断率从9.7%上升到12.5%，但差异无统计学意义(P=0.143)。结论：实施现场干预后，结核病推定病例的取痰率、痰质量和痰量均有不同程度的提高。为了提高痰标本采集率，项目层面的努力应该持续下去。
Setting: Twenty-two human immunodeficiency virus (HIV) clinics in Botswana.Objective: To compare sputum collection rates, sputum quality and volume, and tuberculosis (TB) diagnosis rates before and after field efforts to improve sputum collection among individuals newly diagnosed with HIV with TB symptoms.Design: Newly diagnosed individuals living with HIV attending 22 HIV clinics in Botswana were screened for TB from August 2012 to March 2014. Starting in May 2013, a field intervention composed of the introduction of a tracking log for presumed TB patients, and patient instructions and sputum induction to improve sputum collection rates was implemented.Results: Prior to the intervention, sputum collection rates were 44.1% (384/870). Subsequently, sputum collection increased to 58.3% (579/993) (P < 0.001). Sputum quality and volume also improved. Although rates of TB diagnosis increased from 9.7% (84/870) to 12.5% (120/993), this difference was not significant (P = 0.143).Conclusion: Sputum collection rates among presumptive TB cases, as well as sputum quality and volume improved after implementation of the field intervention. To improve sputum collection rates, efforts at the program level should be ongoing.