Tuberculosis case detection by trained inmate peer educators in a resource-limited prison setting in Ethiopia: a cluster-randomised trial
Tuberculosis case detection by trained inmate peer educators in a resource-limited prison setting in Ethiopia: a cluster-randomised trial
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DOI：
10.1016/s2214-109x(18)30477-7
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发表时间：
2019-04-01
影响因子：
34.3
通讯作者：
Dinant, Geert-Jan
中科院分区：
文献类型：
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作者：
Adane, Kelemework;Spigt, Mark;Dinant, Geert-Jan
为了提高结核病病例的发现率，需要在现有资源范围内采取可行的干预措施。我们调查是否涉及训练有素的监狱囚犯在结核病控制计划提高结核病病例的发现，缩短治疗前症状的持续时间，并增加治疗的成功，在资源有限的监狱设置在Ethiopia.Methods在这个群集随机试验中，我们随机分配监狱在该地区阿姆哈拉和提格雷埃塞俄比亚的干预组或对照组，根据它们的地理位置和大小将它们配对。较大的监狱被认为符合条件，而较小的监狱则被排除在外。我们在每个干预监狱选择了三到六名囚犯。被招募的囚犯接受了为期3天的培训课程，并能够识别推定的结核病病例，然后每两周向所有其他囚犯提供结核病预防和控制方面的健康教育，为期一年。他们还积极寻找有症状的囚犯，并进行常规的结核病筛查。对照监狱遵循现行的被动案件调查制度。主要成果是年底的平均病例发现率，以集群（监狱）一级衡量。该试验在ClinicalTrials.gov上注册，编号NCT 02744521。结果我们从2016年4月1日至2017年3月31日将16所监狱的18032名囚犯随机分配到干预组（n=8）或对照组（n=8）。在为期一年的研究期间，在干预监狱发现了75例新的结核病病例（占8874名囚犯总数的1%），25例新病例（
Background To improve tuberculosis case detection, interventions that are feasible with available resources are needed. We investigated whether involving trained prison inmates in a tuberculosis control programme improved tuberculosis case detection, shortened pre-treatment symptom duration, and increased treatment success in a resource-limited prison setting in Ethiopia.Methods In this cluster-randomised trial we randomly assigned prisons in the regions Amhara and Tigray of Ethiopia to an intervention group or a control group, after matching them into pairs based on their geographical proximity and size. Larger prisons were considered eligible whereas smaller prisons were excluded. We selected three to six prison inmates in each intervention prison. The recruited prison inmates who received a 3-day training course and were capable of identifying presumptive tuberculosis cases then provided health education to all other prison inmates about tuberculosis prevention and control every 2 weeks for 1 year. They also actively searched for symptomatic prison inmates and undertook routine symptom-based tuberculosis screening. The control prisons followed the existing passive case finding system. The primary outcome was the mean case detection rate at the end of the year, measured at cluster (prison) level. This trial is registered at ClinicalTrials.gov, number NCT02744521.Findings We randomly assigned 16 prisons with a total population of 18 032 inmates to either the intervention group (n=8) or the control group (n=8) from April 1, 2016, to March 31, 2017. During the 1-year study period, 75 new tuberculosis cases (1% of 8874 total inmates) were detected in the intervention prisons and 25 new cases (