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Bonnet Maryline, Kyakwera C., Kyomugasho N., Atwine D., Mugabe F., Nansumba M., Boum Y., Mwanga-Amumpaire J., Kiwanuka J. (2017). Prospective cohort study of the feasibility and yield of household child tuberculosis contact screening in Uganda. International Journal of Tuberculosis and Lung Disease, 21 (8), 862-868. ISSN 1027-3719

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Lien direct chez l'éditeur doi:10.5588/ijtld.16.0889

Titre
Prospective cohort study of the feasibility and yield of household child tuberculosis contact screening in Uganda
Année de publication2017
Type de documentArticle référencé dans le Web of Science WOS:000406895600006
AuteursBonnet Maryline, Kyakwera C., Kyomugasho N., Atwine D., Mugabe F., Nansumba M., Boum Y., Mwanga-Amumpaire J., Kiwanuka J.
SourceInternational Journal of Tuberculosis and Lung Disease, 2017, 21 (8), p. 862-868. ISSN 1027-3719
RésuméSETTING: Screening and isoniazid preventive therapy (IPT) of child contacts of tuberculosis (TB) patients is 'poorly implemented in resource-limited countries, in part due to difficulties in TB diagnosis in children. OBJECTIVE: To assess the feasibility and yield of hospital-based screening and IPT in Uganda, and to evaluate the utility of symptom-based screening. DESIGN: Household child (age <5 years) contacts of adults with pulmonary TB were assessed for TB or latent tuberculous infection (LTBI). Children classified as 'LTBI' or 'uninfected' were prescribed IPT and followed for 9 months. Screening algorithms based on combinations of symptoms associated with TB were constructed post hoc, and their performance evaluated against a radiological-based reference standard. RESULTS: Of 281 contacts (median age 33 months), 44 (15.7%) started anti-tuberculosis treatment and 234 (83.3%) received IPT, 80.3% of whom completed a 6 month course. After adjustment for age and human immunodeficiency virus status, cough (aOR 4.10, 95%CI 1.39-12.11) and reduced playfulness (aOR 7.79, 95%CI 2.12-25.18) were associated with radiological TB. Screening based on cough or reduced playfulness had a sensitivity of 81.8% and a negative predictive value of 97.6%. CONCLUSION: Hospital-based screening appears to be feasible, and confirms the potential utility of symptom based screening to select children for IPT and those for further investigations.
Plan de classementSanté : généralités [050]
Descr. géo.OUGANDA
LocalisationFonds IRD [F B010070905]
Identifiant IRDfdi:010070905
Lien permanenthttp://www.documentation.ird.fr/hor/fdi:010070905

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