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. 2024 Mar 8;14(3):e079794.
doi: 10.1136/bmjopen-2023-079794.

National cross-sectional cluster survey of tuberculosis prevalence in Timor-Leste: a study protocol

Constantino Lopes  1 , Josefina Clarinha Joao  1 , Christopher Lowbridge  2 , Nelson Martins  3 , Rofina Isabel Gusmão Dos Santos  3 , Endang da Silva  4 , Joana Dias  4 , Sureshbabu Ramalingam  4 , Salvador Amaral  3 , Tessa Oakley  3 , Lourenco da Costa Ico  3 , Nevio Sarmento  3 , Jennifer Yan  3   5 , Joshua Reginald Francis  3   5
Affiliations

National cross-sectional cluster survey of tuberculosis prevalence in Timor-Leste: a study protocol

Constantino Lopes et al. BMJ Open. .

Abstract

Introduction: Timor-Leste has one of the world's highest estimated tuberculosis (TB) incidences, yet the data which informs this estimate is limited and the true burden of TB disease is not known. TB prevalence surveys offer the best means of determining robust estimates of disease burden. This study aims to provide an estimate of the prevalence of bacteriologically confirmed pulmonary TB in Timor-Leste and provide additional insights into diagnostic coverage and health-seeking behaviour of persons with symptoms suggestive of TB.

Methods and analysis: A national population-based cross-sectional cluster survey will be conducted in which participants aged 15 years and older will be screened for pulmonary TB using an algorithm consisting of symptom screening and digital X-ray of the chest with computer-aided detection software for X-ray interpretation. Xpert Ultra and liquid culture methods will be used to confirm survey TB cases. Additional data will be collected from persons reporting symptoms suggestive of TB to assess health-seeking behaviour and access to TB diagnosis and care. The survey aims to screen a target sample population of 20 068 people, living within 50 clusters, representing every municipality of Timor-Leste. Bacteriologically confirmed pulmonary TB prevalence will be estimated using WHO-recommended methods.

Ethics and dissemination: Research ethics approval has been granted by the human research ethics committee of the Northern Territory, Australia, and the Instituto Nacional da Saúde, Timor-Leste. The results will be published in a peer-reviewed scientific journal and disseminated with relevant stakeholders.

Trial registration number: ACTRN12623000718640.

Keywords: EPIDEMIOLOGIC STUDIES; Public health; Respiratory infections; Tuberculosis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Survey screening and diagnostic testing algorithm. AI, artificial intelligence; MGIT, Mycobacteria Growth Indicator Tube; TB, tuberculosis.
See this image and copyright information in PMC

References

    1. Deen J, Matos L da C, Temple B, et al. . Identifying national health research priorities in Timor-Leste through a Scoping review of existing health data. Health Res Policy Syst 2013;11:8. 10.1186/1478-4505-11-8 - DOI - PMC - PubMed
    1. Ministerio da Suade . National strategic plan for ending TB 2020-2024. In: In: National Tuberculosis Control Program. Ministerio da Suade, 2020.
    1. World Health Organization . Global tuberculosis report 2022. Geneva: World Health Organization; 2022.
    1. World Health Organization . Tuberculosis country profiles: Timor-Leste Geneva: world health Organisation. Available: https://worldhealthorg.shinyapps.io/tb_profiles [Accessed 20 Dec 2022].
    1. World Health Organization . Tuberculosis Prevalence Surveys: a handbook. Geneva: World Health Organization, 2011.

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