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GeneXpert and Community Health Workers Supported Patient Tracing for Tuberculosis Diagnosis in Conflict-Affected Border Areas in India

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Médecins Sans Frontières/Doctors Without Borders, Delhi 110024, India
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Médecins Sans Frontières/Doctors Without Borders, Bhadrachalam, Telangana 507111, India
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District TB Office, RNTCP, Bhadrachalam district hospital, Bhadrachalam, Telangana 507111, India
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Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town 7925, South Africa
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Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2020, 5(1), 1; https://doi.org/10.3390/tropicalmed5010001
Received: 19 November 2019 / Revised: 11 December 2019 / Accepted: 11 December 2019 / Published: 21 December 2019
Médecins Sans Frontières (MSF) has been providing diagnosis and treatment for patients with tuberculosis (TB) via mobile clinics in conflict-affected border areas of Chhattisgarh, India since 2009. The study objectives were to determine the proportion of patients diagnosed with TB and those who were lost-to-follow-up (LTFU) prior to treatment initiation among patients with presumptive TB between April 2015 and August 2018. The study also compared bacteriological confirmation and pretreatment LTFU during two time periods: a) April 2015–August 2016 and b) April 2017–August 2018 (before and after the introduction of GeneXpert as a first diagnostic test). Community health workers (CHW) supported patient tracing. This study was a retrospective analysis of routine program data. Among 1042 patients with presumptive TB, 376 (36%) were diagnosed with TB. Of presumptive TB patients, the pretreatment LTFU was 7%. Upon comparing the two time-periods, bacteriological confirmation increased from 20% to 33%, while pretreatment LTFU decreased from 11% to 4%. TB diagnosis with GeneXpert as the first diagnostic test and CHW-supported patient tracing in a mobile-clinic model of care shows feasibility for replication in similar conflict-affected, hard to reach areas. View Full-Text
Keywords: sputum; health promotion; operational research; indigenous population sputum; health promotion; operational research; indigenous population
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Das, M.; Pasupuleti, D.; Rao, S.; Sloan, S.; Mansoor, H.; Kalon, S.; Hossain, F.N.; Ferlazzo, G.; Isaakidis, P. GeneXpert and Community Health Workers Supported Patient Tracing for Tuberculosis Diagnosis in Conflict-Affected Border Areas in India. Trop. Med. Infect. Dis. 2020, 5, 1.

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