Investigating the acceptability and feasibility of home-based TB testing of household contacts using a new, mobile point-of-care technology

调查使用新型移动护理点技术对家庭接触者进行家庭结核病检测的可接受性和可行性

• 批准号: 9165353
• 负责人: Andrew Medina-Marino
• 金额: $ 14.83万
• 依托单位: FOUNDATION FOR PROFESSIONAL DEVELOPMENT
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-15 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9165353
• 关键词: Address; Area; Buffaloes; Care Technology Points; Caring; Cities; Clinic; Communities; Consent; Contact Tracing; Country; Databases; Detection; Development; Diagnosis; Diagnostic; Disease; Early Diagnosis; Effectiveness; Epidemic; Foundations; Goals; Guidelines; HIV diagnosis; Health; Health care facility; Home environment; Household; Individual; Intervention; Investigation; Lead; Link; Morbidity - disease rate; Outcome; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Population; Predisposition; Prevalence; Province; Recruitment Activity; Reporting; Research; Research Project Grants; South Africa; South African; Stress; Symptoms; System; Testing; Time; Tuberculosis; Wireless Technology; base; care seeking; case finding; cost effective; experience; follow-up; health seeking behavior; high risk; improved; indexing; innovation; mortality; point of care; programs; rapid diagnosis; response; screening; success; transmission process; uptake

PROJECT SUMMARY / ABSTRACT In 2013, WHO estimated that 3.3 million cases of TB had been missed (undiagnosed or with a significant delay in diagnosis or treatment). “Missed” TB cases are a key driver of TB transmission, with approximately 9 million individuals developing TB globally each year, equivalent to 126 cases per 100,000 population. The overall goal of this proposal is to evaluate the utility of home-based point-of-care TB testing for early diagnosis and linkage to care of household contacts of TB patients, addressing the need for intensive case finding and early detection of infectious TB. Although well-accepted as an effective strategy for boosting HIV diagnosis and treatment rates, until recently home-based testing for TB has been impossible, as there has never existed an effective, mobile PoC technology for rapid diagnosis of TB. With the development of the new GeneXpert® Omni diagnostic platform from Cepheid, home-based TB testing is now possible. Now is the time to study whether home-based testing for TB is feasible, and will contribute to early case detection or improve time-to-treatment rates. Our project has two Specific Aims: 1) To determine the acceptability and feasibility of using point-of-care technology to perform home-based TB testing of household contacts of TB patients, with subaim 1(a): To assess the intent-to-seek care of household contacts symptomatic for TB, and subaim 1(b): To determine the proportion of household contacts symptomatic for TB consenting to be tested (acceptability) and uptake of treatment referrals by those individuals infected with TB within two weeks of testing (feasibility); and 2) To describe the outcomes of household contacts screened and tested for TB in their home compared to those screened and referred for testing in a health facility, with subaim 2(a): To describe the barriers and facilitators to clinic follow-up by household contacts symptomatic for TB and provided with referral for TB testing or treatment initiation, and subaim 2(b): To determine whether point-of-care home-based TB testing reduces time-to-treatment initiation. This study will recruit TB index patients from the 5 health facilities that serve the Duncan Village Informal Settlement Area in Buffalo City Metro Health District, Eastern Cape Province, South Africa, a very high TB prevalence area. Findings from this project may represent a new strategy for increasing TB case finding and improving linkage to care for the 3 million missed cases of TB annually. Furthermore, early detection of TB disease, with improved linkage to care rates, may reduce TB transmission and prevalence in high-burden settings.

项目摘要 /摘要 2013年，他估计错过了330万病例的结核病（未诊断或延迟很大 “错过”结核病案件是结核病传输的关键驱动力，约有900万 每年在全球开发结核病的人，相当于每10万人人口126例。总体目标 该建议的是评估基于家庭的护理点结核病测试的早期诊断和联系的效用 照顾结核病患者的家庭接触，以解决密集的病例发现的需求 检测感染性TB。尽管被良好接受为增强HIV诊断和的有效策略 治疗率直到最近对结核病的家庭测试一直是不可能的，因为从来没有 有效的移动POC技术，用于快速诊断结核病。随着新的GenExpert®omni的发展 Cepheid的诊断平台，基于家庭的结核病测试是可能的。现在是时候研究了是否 基于家庭的结核病测试是可行的，将有助于早期病例检测或改善治疗时间 费率。 我们的项目有两个具体的目的：1）确定使用现实点的可接受性和可行性 对结核病患者进行家庭接触的基于家庭的结核病测试，SUBAIM 1（a）： 评估针对结核病的家庭接触的意向，以及Subaim 1（b）：确定 家庭接触的比例是有症状的结核病同意测试（可接受性）和吸收的比例 那些在测试后的两周内感染了结核病的人的治疗转诊（可行性）；和2）到 与那些相比 筛选并提及在医疗机构中进行的测试，以及Subaim 2（a）：描述障碍和促进者 通过家庭接触对结核病的诊所随访，并提供了TB测试的推荐或 治疗计划和Subaim 2（b）：确定基于护理的家庭结核病测试是否会减少 处理时间倡议。 这项研究将招募为邓肯村非正式服务的5个医疗机构的结核病指数患者 南非东开普省布法罗市地铁卫生区的定居区，一个很高的结核病 患病率区域。该项目的调查结果可能代表了增加结核病病例查找和的新策略 改善每年有300万例TB案件的链接，以照顾300万例。此外，TB的早期检测 疾病与护理率的联系有所提高，可能会降低TB的传播和高负荷的患病率 设置。