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The Presence of Cough and Tuberculosis: Active Case Finding Outcomes in the Philippines

机译:咳嗽和肺结核的存在:在菲律宾积极寻找病例的结果

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摘要

The results of a tuberculosis (TB) active case finding (ACF) program, implemented by International Care Ministries (ICM) in the Philippines, were examined to understand how the presence of physical symptoms might influence ACF outcomes among extreme low-income Filipinos. ICM health staff implemented symptom screening in villages and suspected cases were referred to the closest rural health unit (RHU) for TB testing. ACF was carried out in Mindanao and the Visayas, across 16 different provinces. All participants were interviewed pre/postprogram, and screening outcomes were collected. A multilevel regression model was constructed to explore the effect of factors on the likelihood of getting tested. A total of 4635 individuals were screened; 1290 (27.8%) were symptom positive and referred. From those referred, 336 (7.2%) were tested for TB and 53 (1.1%) were TB positive. “Cough for more than two weeks” was associated with a 1.09 (95% CI 1.01, 1.15) times increase in likelihood of getting tested. The finding that the presence of cough is associated with higher rate of testing suggests that individuals in these settings might not know or believe that the lack of cough does not equate to lack of TB infection. While technologies and screening algorithms give us the ability to refine the ‘supply' side of the TB screening, addressing the knowledge gap should improve ‘demand'.
机译:由菲律宾国际护理部(ICM)实施的结核病(TB)主动病例发现(ACF)计划的结果进行了检查,以了解物理症状的存在如何影响极低收入菲律宾人的ACF结果。 ICM卫生人员在村庄进行了症状筛查,将疑似病例转至最近的农村卫生单位(RHU)进行结核病检测。 ACF在棉兰老岛和米沙ya群岛的16个不同省份进行。对所有参与者在节目前/节目后进行了采访,并收集了筛查结果。构建了一个多级回归模型,以探讨因素对测试可能性的影响。总共筛选了4635个人;症状阳性并转诊为1290(27.8%)。从所提及的患者中,有336名(7.2%)进行了结核病检测,其中53名(1.1%)呈结核阳性。 “咳嗽超过两周”与被检测的可能性增加了1.09倍(95%CI 1.01,1.15)有关。咳嗽的存在与更高的检测率有关的发现表明,在这些情况下的个体可能不知道或认为缺乏咳嗽并不等于缺乏结核感染。尽管技术和筛查算法使我们能够完善结核病筛查的“供应”面,但解决知识鸿沟应该可以改善“需求”。

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