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Optimizing Active Tuberculosis Case Finding: Evaluating the Impact of Community Referral for Chest X-ray Screening and Xpert Testing on Case Notifications in Two Cities in Viet Nam
Open AccessArticle

An Evaluation of Programmatic Community-Based Chest X-ray Screening for Tuberculosis in Ho Chi Minh City, Vietnam

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Pham Ngoc Thach Hospital, Ho Chi Minh City 700 000, Vietnam
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Friends for International TB Relief, Ho Chi Minh City 700 000, Vietnam
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Interactive Research and Development, Singapore 238884, Singapore
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IRD VN, Ho Chi Minh City 700 000, Vietnam
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Ho Chi Minh City Public Health Association, Ho Chi Minh City 700 000, Vietnam
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Clinton Health Access Initiative Vietnam, Ha Noi 100 000, Vietnam
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Ho Chi Minh City Department of Health, Ho Chi Minh City 700 000, Vietnam
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Stop TB Partnership, 1218 Geneva, Switzerland
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Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
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Birat Nepal Medical Trust Nepal, Kathmandu 44600, Nepal
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Viet Nam National Lung Hospital, Ha Noi 100 000, Vietnam
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2020, 5(4), 185; https://doi.org/10.3390/tropicalmed5040185
Received: 30 September 2020 / Revised: 28 October 2020 / Accepted: 12 November 2020 / Published: 10 December 2020
Across Asia, a large proportion of people with tuberculosis (TB) do not report symptoms, have mild symptoms or only experience symptoms for a short duration. These individuals may not seek care at health facilities or may be missed by symptom screening, resulting in sustained TB transmission in the community. We evaluated the yields of TB from 114 days of community-based, mobile chest X-ray (CXR) screening. The yields at each step of the TB screening cascade were tabulated and we compared cohorts of participants who reported having a prolonged cough and those reporting no cough or one of short duration. We estimated the marginal yields of TB using different diagnostic algorithms and calculated the relative diagnostic costs and cost per case for each algorithm. A total of 34,529 participants were screened by CXR, detecting 256 people with Xpert-positive TB. Only 50% of those diagnosed with TB were detected among participants reporting a prolonged cough. The study’s screening algorithm detected almost 4 times as much TB as the National TB Program’s standard diagnostic algorithm. Community-based, mobile chest X-ray screening can be a high yielding strategy which is able to identify people with TB who would likely otherwise have been missed by existing health services. View Full-Text
Keywords: tuberculosis; TB; chest X-ray; active TB case-finding; diagnostic algorithm tuberculosis; TB; chest X-ray; active TB case-finding; diagnostic algorithm
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MDPI and ACS Style

Nguyen, L.H.; Codlin, A.J.; Vo, L.N.Q.; Dao, T.; Tran, D.; Forse, R.J.; Vu, T.N.; Le, G.T.; Luu, T.; Do, G.C.; Truong, V.V.; Minh, H.D.T.; Nguyen, H.H.; Creswell, J.; Caws, M.; Nguyen, H.B.; Nguyen, N.V. An Evaluation of Programmatic Community-Based Chest X-ray Screening for Tuberculosis in Ho Chi Minh City, Vietnam. Trop. Med. Infect. Dis. 2020, 5, 185. https://doi.org/10.3390/tropicalmed5040185

AMA Style

Nguyen LH, Codlin AJ, Vo LNQ, Dao T, Tran D, Forse RJ, Vu TN, Le GT, Luu T, Do GC, Truong VV, Minh HDT, Nguyen HH, Creswell J, Caws M, Nguyen HB, Nguyen NV. An Evaluation of Programmatic Community-Based Chest X-ray Screening for Tuberculosis in Ho Chi Minh City, Vietnam. Tropical Medicine and Infectious Disease. 2020; 5(4):185. https://doi.org/10.3390/tropicalmed5040185

Chicago/Turabian Style

Nguyen, Lan H.; Codlin, Andrew J.; Vo, Luan N.Q.; Dao, Thang; Tran, Duc; Forse, Rachel J.; Vu, Thanh N.; Le, Giang T.; Luu, Tuan; Do, Giang C.; Truong, Vinh V.; Minh, Ha D.T.; Nguyen, Hung H.; Creswell, Jacob; Caws, Maxine; Nguyen, Hoa B.; Nguyen, Nhung V. 2020. "An Evaluation of Programmatic Community-Based Chest X-ray Screening for Tuberculosis in Ho Chi Minh City, Vietnam" Trop. Med. Infect. Dis. 5, no. 4: 185. https://doi.org/10.3390/tropicalmed5040185

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