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Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar

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Center for Operational Research, International Union Against Tuberculosis and Lung Disease, Myanmar Office, Mandalay 05021, Myanmar
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Center for Operational Research, International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi 110016, India
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Center for Operational Research, International Union Against Tuberculosis and Lung Disease, 75006 Paris, France
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Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru 575018, India
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National Tuberculosis Programme, Department of Public Health, Nay Pyi Taw 15011, Myanmar
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Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2020, 5(1), 2; https://doi.org/10.3390/tropicalmed5010002
Received: 16 October 2019 / Revised: 3 November 2019 / Accepted: 13 November 2019 / Published: 25 December 2019
Screening of household contacts of patients with multidrug-resistant tuberculosis (MDR-TB) is a crucial active TB case-finding intervention. Before 2016, this intervention had not been implemented in Myanmar, a country with a high MDR-TB burden. In 2016, a community-based screening of household contacts of MDR-TB patients using a systematic TB-screening algorithm (symptom screening and chest radiography followed by sputum smear microscopy and Xpert-MTB/RIF assays) was implemented in 33 townships in Myanmar. We assessed the implementation of this intervention, how well the screening algorithm was followed, and the yield of active TB. Data collected between April 2016 and March 2017 were analyzed using logistic and log-binomial regression. Of 620 household contacts of 210 MDR-TB patients enrolled for screening, 620 (100%) underwent TB symptom screening and 505 (81%) underwent chest radiography. Of 240 (39%) symptomatic household contacts, 71 (30%) were not further screened according to the algorithm. Children aged <15 years were less likely to follow the algorithm. Twenty-four contacts were diagnosed with active TB, including two rifampicin- resistant cases (yield of active TB = 3.9%, 95% CI: 2.3%–6.5%). The highest yield was found among children aged <5 years (10.0%, 95% CI: 3.6%–24.7%). Household contact screening should be strengthened, continued, and scaled up for all MDR-TB patients in Myanmar. View Full-Text
Keywords: multidrug-resistant tuberculosis; household contact; screening; TB diagnosis; yield; operations research multidrug-resistant tuberculosis; household contact; screening; TB diagnosis; yield; operations research
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Kyaw, N.T.T.; Sithu, A.; Satyanarayana, S.; Kumar, A.M.V.; Thein, S.; Thi, A.M.; Wai, P.P.; Lin, Y.N.; Kyaw, K.W.Y.; Tun, M.M.T.; Oo, M.M.; Aung, S.T.; Harries, A.D. Outcomes of Community-Based Systematic Screening of Household Contacts of Patients with Multidrug-Resistant Tuberculosis in Myanmar. Trop. Med. Infect. Dis. 2020, 5, 2.

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