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. 2022 Feb 18;17(2):e0264216.
doi: 10.1371/journal.pone.0264216. eCollection 2022.

Age-specific effectiveness of a tuberculosis screening intervention in children

Meredith B Brooks  1 , Melanie M Dubois  2   3 , Amyn A Malik  4   5 , Junaid F Ahmed  6 , Sara Siddiqui  6 , Salman Khan  7 , Manzoor Brohi  8 , Teerath Das Valecha  7 , Farhana Amanullah  6 , Mercedes C Becerra  1 , Hamidah Hussain  5
Affiliations

Age-specific effectiveness of a tuberculosis screening intervention in children

Meredith B Brooks et al. PLoS One. .

Abstract

Objective: To apply a cascade-of-care framework to evaluate the effectiveness-by age of the child-of an intensified tuberculosis patient-finding intervention.

Design: From a prospective screening program at four hospitals in Pakistan (2014-2016) we constructed a care cascade comprising six steps: screened, positive screen, evaluated, diagnosed, started treatment, and successful outcome. We evaluated the cascade by each year of age from 0 to 14 and report the age-specific mean proportion and standard deviation.

Results: On average across all ages, only 12.5% (standard deviation: 2.0%) of children with a positive screen were not evaluated. Among children who had a complete evaluation, the highest percentages of children diagnosed with tuberculosis were observed in children 0-4 (mean: 31.9%; standard deviation: 4.8%), followed by lower percentages in children 5-9 (mean: 22.4%; standard deviation: 2.2%), and 10-14 (mean: 26.0%; standard deviation:5.4%). Nearly all children diagnosed with tuberculosis initiated treatment, and an average of 93.3% (standard deviation: 3.3%) across all ages had successful treatment outcomes.

Conclusions: This intervention was highly effective across ages 0-14 years. Our study illustrates the utility of applying operational analyses of age-stratified cascades to identify age-specific gaps in pediatric tuberculosis care that can guide future, novel interventions to close these gaps.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Process map for facility-based intervention to detect TB in children.
Fig 2
Fig 2. Steps in the childhood tuberculosis care cascade from screening to treatment outcome.
Fig 3
Fig 3. Percentage of children completing each step of the care cascade, by age.
Fig 4
Fig 4. Cumulative percentages of all children with a positive screen completing each step of care cascade, by age.
Fig 5
Fig 5. Percentage of children completing each step of the care cascade, by age and gender.
See this image and copyright information in PMC

References

    1. Dodd PJ, Yuen CM, Sismanidis C, Seddon JA, Jenkins HE. The global burden of tuberculosis mortality in children: a mathematical modelling study. Lancet Glob Health 2017; 5(9):e898–e906. doi: 10.1016/S2214-109X(17)30289-9 - DOI - PMC - PubMed
    1. WHO. Global Tuberculosis Report 2021. World Health Organization. Geneva, Switzerland; 2021.
    1. Dodd PJ, Gardiner E, Coghlan R, Seddon JA. Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health 2014; 2:453–459. doi: 10.1016/S2214-109X(14)70245-1 - DOI - PubMed
    1. Dodd PJ, Sismanidis C, Seddon JA. Global burden of drug-resistant tuberculosis in children: a mathematical modelling study. Lancet Infect Dis 2016; 16(10):1193–1201. doi: 10.1016/S1473-3099(16)30132-3 - DOI - PubMed
    1. Jenkins HE, Tolman AW, Yuen CM, et al.. Incidence of multidrug-resistant tuberculosis disease in children: systematic review and global estimates. Lancet 2014; 383(9928):1572–1579. doi: 10.1016/S0140-6736(14)60195-1 - DOI - PMC - PubMed

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