The Impact of Funding on Childhood TB Case Detection in Pakistan

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

This study is a review of routine programmatically collected data to describe the 5-year trend in childhood case notification in Jamshoro district, Pakistan from January 2013 to June 2018 and review of financial data for the two active case finding projects implemented during this period. The average case notification in the district was 86 per quarter before the start of active case finding project in October 2014. The average case notification rose to 322 per quarter during the implementation period (October 2014 to March 2016) and plateaued at 245 per quarter during the post-implementation period (April 2016 to June 2018). In a specialized chest center located in the district, where active case finding was re-introduced during the post implementation period (October 2016), the average case notification was 218 per quarter in the implementation period and 172 per quarter in the post implementation period. In the rest of the district, the average case notification was 160 per quarter in the implementation period and 78 during the post implementation period. The cost per additional child with TB found ranged from USD 28 to USD 42 during the interventions. A continuous stream of resources is necessary to sustain high notifications of childhood TB.

Related collections

Most cited references 17

Record: found
Abstract: found
Article: found

Is Open Access

The global burden of tuberculosis mortality in children: a mathematical modelling study

Peter Dodd, Courtney M. Yuen, Charalambos Sismanidis … (2017)

Summary Background Tuberculosis in children is increasingly recognised as an important component of the global tuberculosis burden, with an estimated 1 million cases in 2015. Although younger children are vulnerable to severe forms of tuberculosis disease, no age-disaggregated estimates of paediatric tuberculosis mortality exist, and tuberculosis has never been included in official estimates of under-5 child mortality. We aimed to produce a global mortality burden estimate in children using a complementary approach not dependent on vital registration data. Methods In this mathematical modelling study, we estimated deaths in children younger than 5 years and those aged 5–14 years for 217 countries and territories using a case-fatality-based approach. We used paediatric tuberculosis notification data and HIV and antiretroviral treatment estimates to disaggregate the WHO paediatric tuberculosis incidence estimates by age, HIV, and treatment status. We then applied systematic review evidence on corresponding case-fatality ratios. Findings We estimated that 239 000 (95% uncertainty interval [UI] 194 000–298 000) children younger than 15 years died from tuberculosis worldwide in 2015; 80% (191 000, 95% UI 132 000–257 000) of these deaths were in children younger than 5 years. More than 70% (182 000, 140 000–239 000) of deaths occurred in the WHO southeast Asia and Africa regions. We estimated that 39 000 (17%, 23 000–73 000) paediatric tuberculosis deaths worldwide were in children with HIV infections, with 31 000 (36%, 19 000–59 000) in the WHO Africa region. More than 96% (230 000, 185 000–289 000) of all tuberculosis deaths occurred in children not receiving tuberculosis treatment. Interpretation Tuberculosis is a top ten cause of death in children worldwide and a key omission from previous analyses of under-5 mortality. Almost all these deaths occur in children not on tuberculosis treatment, implying substantial scope to reduce this burden. Funding UNITAID, National Institutes of Health, and National Institute for Health Research.

0 comments Cited 134 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Engaging the private sector to increase tuberculosis case detection: an impact evaluation study.

Aamir Khan, Saira Khowaja, Faisal Khan … (2012)

In many countries with a high burden of tuberculosis, most patients receive treatment in the private sector. We evaluated a multifaceted case-detection strategy in Karachi, Pakistan, targeting the private sector. A year-long communications campaign advised people with 2 weeks or more of productive cough to seek care at one of 54 private family medical clinics or a private hospital that was also a national tuberculosis programme (NTP) reporting centre. Community laypeople participated as screeners, using an interactive algorithm on mobile phones to assess patients and visitors in family-clinic waiting areas and the hospital's outpatient department. Screeners received cash incentives for case detection. Patients with suspected tuberculosis also came directly to the hospital's tuberculosis clinic (self-referrals) or were referred there (referrals). The primary outcome was the change (from 2010 to 2011) in tuberculosis notifications to the NTP in the intervention area compared with that in an adjacent control area. Screeners assessed 388,196 individuals at family clinics and 81,700 at Indus Hospital's outpatient department from January-December, 2011. A total of 2416 tuberculosis cases were detected and notified via the NTP reporting centre at Indus Hospital: 603 through family clinics, 273 through the outpatient department, 1020 from self-referrals, and 520 from referrals. In the intervention area overall, tuberculosis case notification to the NTP increased two times (from 1569 to 3140 cases) from 2010 to 2011--a 2·21 times increase (95% CI 1·93-2·53) relative to the change in number of case notifications in the control area. From 2010 to 2011, pulmonary tuberculosis notifications at Indus Hospital increased by 3·77 times for adults and 7·32 times for children. Novel approaches to tuberculosis case-finding involving the private sector and using laypeople, mobile phone software and incentives, and communication campaigns can substantially increase case notification in dense urban settings. TB REACH, Stop TB Partnership. Copyright © 2012 Elsevier Ltd. All rights reserved.

0 comments Cited 68 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A critical review of diagnostic approaches used in the diagnosis of childhood tuberculosis.

Anneke C. Hesseling, R. Gie, N. Beyers … (2002)

The diagnosis of tuberculosis (TB) in children is seldom confirmed, and is based mainly on clinical signs, symptoms and special investigations. Various attempts in the form of diagnostic approaches have been made to rationalise this diagnostic process. To review and describe published diagnostic approaches aimed at diagnosing mainly intrathoracic tuberculosis in children in developing countries; to compare diagnostic approaches with each other and with bacteriologically confirmed TB; and to describe modifications to the diagnosis of TB in HIV-infected or malnourished children. Literature review classified into 1) diagnostic approaches, 2) characteristics used in diagnostic approaches, and 3) studies done to validate diagnostic approaches. Sixteen systems were analysed. Comparison of systems is difficult because characteristic definitions and the ranking of characteristics are not standardised, few studies have been performed to validate these diagnostic approaches, and the gold standard of diagnosis is not practicable in most settings. The minority of systems are adapted for HIV-infected and malnourished patients. Characteristic definitions and ranking of characteristics should be standardised. Any new diagnostic approaches developed should be relevant to developing countries with limited resources, a high burden of tuberculosis, malnutrition and HIV/AIDS and a young population. Studies done to validate diagnostic approaches should be conducted scientifically.

0 comments Cited 45 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Trop Med Infect Dis

Journal ID (iso-abbrev): Trop Med Infect Dis

Journal ID (publisher-id): tropicalmed

Title: Tropical Medicine and Infectious Disease

Publisher: MDPI

ISSN (Electronic): 2414-6366

Publication date (Electronic): 15 December 2019

Publication date Collection: December 2019

Volume: 4

Issue: 4

Electronic Location Identifier: 146

Affiliations

[1 ]Global Health Directorate, Indus Health Network, Karachi 75190, Pakistan; sara.siddiqui@ 123456ghd.ihn.org.pk (S.S.); junaid.fuad@ 123456ghd.ihn.org.pk (J.F.A.); falak.madhani@ 123456ghd.ihn.org.pk (F.M.)

[2 ]Interactive Research and Development (IRD) Global, Singapore 189677, Singapore; hamidah.hussain@ 123456ird.global (H.H.); aamir.khan@ 123456ird.global (A.J.K.)

[3 ]Emory University Rollins School of Public Health, Atlanta, GA 30329, USA

[4 ]Stop TB Partnership, 1218 Le Grand-Saconnex, Switzerland; jacobc@ 123456stoptb.org

[5 ]Interactive Health Solutions, Karachi 75350, Pakistan; ali.habib@ 123456ihsinformatics.com

[6 ]The Indus Hospital, Karachi 75190, Pakistan; farhana.maqbool@ 123456ird.global

Author notes

[* ]Correspondence: amyn.malik@ 123456ghd.ihn.org.pk

Author information

Amyn A. Malik https://orcid.org/0000-0003-4875-9916

Jacob Creswell https://orcid.org/0000-0002-4885-940X

Ali Habib https://orcid.org/0000-0003-2602-9146

Article

Publisher ID: tropicalmed-04-00146

DOI: 10.3390/tropicalmed4040146

PMC ID: 6958435

PubMed ID: 31847497

SO-VID: e594c98e-8602-4430-b773-644b85a95903

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

The Impact of Funding on Childhood TB Case Detection in Pakistan

Read this article at

Abstract

Related collections

ScienceOpen Clinical Case Reports Collection

Most cited references 17

The global burden of tuberculosis mortality in children: a mathematical modelling study

Engaging the private sector to increase tuberculosis case detection: an impact evaluation study.

A critical review of diagnostic approaches used in the diagnosis of childhood tuberculosis.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Categories

Comments

Comment on this article

Similar content 184

Cited by 9

Most referenced authors 250