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Comparing additionality of tuberculosis cases using GeneXpert or smear-based active TB case-finding strategies among social contacts of index cases in Nepal

Abstract:
This study compares the yield and additionality of community-based active tuberculosis (TB) active case-finding strategies using either smear microscopy or GeneXpert as the TB diagnostic test. Active case-finding strategies screened social contacts of index cases and high-risk groups in four districts of Nepal in July 2017–2019. Two districts (Chitwan and Dhanusha) applied GeneXpert testing and two districts (Makwanpur and Mahotarri) used smear microscopy. Two control districts implemented standard national TB program activities. Districts implementing GeneXpert testing screened 23,657 people for TB, tested 17,114 and diagnosed 764 TB cases, producing a yield of 4.5%. Districts implementing smear microscopy screened 19,961 people for TB, tested 13,285 and diagnosed 437 cases, producing a yield of 3.3%. The screening numbers required were 31 for GeneXpert and 45.7 for smear districts. The test numbers required were 22.4 and 30.4 for GeneXpert and smear. Using the TB REACH additionality method, social contact tracing for TB through GeneXpert testing contributed to a 20% (3958/3322) increase in district-level TB notifications, smear microscopy 12.4% (3146/2798), and −0.5% (2553/2566) for control districts. Therefore, social contact tracing of TB index cases using GeneXpert testing should be implemented throughout Nepal within the TB FREE initiative to close the notification gap and accelerate progress toward END TB strategy targets.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3390/tropicalmed8070369

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Role:
Author
ORCID:
0000-0002-4012-7562
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Role:
Author
ORCID:
0000-0002-7957-8109
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Role:
Author
ORCID:
0000-0001-5929-5585


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Funder identifier:
https://ror.org/00k4n6c32
Grant:
733174
Programme:
Horizon 2020—IMPACT TB project


Publisher:
MDPI
Journal:
Tropical Medicine and Infectious Disease More from this journal
Volume:
8
Issue:
7
Article number:
369
Place of publication:
Switzerland
Publication date:
2023-07-17
Acceptance date:
2023-07-13
DOI:
EISSN:
2414-6366
ISSN:
2414-6366
Pmid:
37505665


Language:
English
Keywords:
Pubs id:
1496312
Local pid:
pubs:1496312
Deposit date:
2025-02-14
ARK identifier:

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