加纳医疗机构中活动性肺结核病例发现：基于症状的筛查工具的效果和敏感性。

Active tuberculosis case findings in Ghanaian health facilities: effectiveness and sensitivity of the symptoms-based screening tool.

机构信息

Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Hohoe, Ghana.

Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.

出版信息

Pan Afr Med J. 2021 Oct 20;40:111. doi: 10.11604/pamj.2021.40.111.28798. eCollection 2021.

DOI:10.11604/pamj.2021.40.111.28798

PMID:34887985

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8627140/

Abstract

INTRODUCTION

the National Tuberculosis Programme (NTP), Ghana, introduced Symptoms-Based Screening (SBS) Tool for TB case finding. This study aimed to determine the challenges and limitations associated with the use of the SBS Tool for active tuberculosis case finding in Ghanaian health facility settings.

METHODS

this study targeted suspected TB patients attending two health facilities in the Ho Municipality, Ghana. Initially, suspected TB patients were screened with the SBS tool and presumptive patients subsequently tested for M. tuberculosis using microscopy and geneXpert assay. Additionally, health personnel were interviewed to assess the user-friendliness, challenges, and limitations associated with the tool.

RESULTS

of 636 presumptive TB patients identified, 1.73% had tuberculosis. Coughing for > 2 weeks (χ=24.8; p<0.05); chest pain (χ=28.3; p<0.01) and night sweat (χ=34.8; p<0.05) associated significantly with M. tuberculosis infection status. The health personnel found the tool to be not user-friendly and it also lacked indicators to identify other vulnerable individuals such as diabetics, cigarette smokers, alcoholics, immunocompromised, and malnourished individuals. Therefore, the SBS tool was found not to be sensitive enough to identify probable cases.

CONCLUSION

the SBS tool is useful for detecting active TB cases, however, it must be improved to identify vulnerable individuals such as diabetics, immunosuppressed, and malnourished.

摘要

简介

加纳国家结核病规划（NTP）引入了基于症状的筛查（SBS）工具来发现结核病病例。本研究旨在确定在加纳卫生机构环境中使用 SBS 工具进行活动性肺结核病例发现所面临的挑战和限制。

方法

本研究针对在加纳霍市的两个卫生机构就诊的疑似结核病患者。最初，疑似结核病患者使用 SBS 工具进行筛查，随后疑似患者使用显微镜和 GeneXpert 检测方法检测结核分枝杆菌。此外，还对卫生人员进行了访谈，以评估该工具的用户友好性、挑战和限制。

结果

在 636 例疑似结核病患者中，1.73%患有结核病。咳嗽时间>2 周（χ²=24.8；p<0.05）；胸痛（χ²=28.3；p<0.01）和夜间出汗（χ²=34.8；p<0.05）与结核分枝杆菌感染状况显著相关。卫生人员发现该工具不便于使用，且缺乏识别其他易感染人群（如糖尿病患者、吸烟者、酗酒者、免疫功能低下者和营养不良者）的指标。因此，SBS 工具被发现识别可能病例的敏感性不够。