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Open Access Impact of intensified case-finding strategies on childhood TB case registration in Nepal

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Setting: Seven intervention districts with intensified childhood tuberculosis (TB) case-finding strategies implemented by a non-governmental organisation and seven control districts under the National Tuberculosis Programme, Nepal.

Objectives: To assess the differences in childhood TB case registrations and case registration rates per 100 000 population between two time periods (Year 1 = March 2012–March 2013 and Year 2 = March 2013–March 2014) in intervention and control districts.

Design: Retrospective record review using routinely collected data.

Results: Childhood TB cases increased from 271 to 360 between Years 1 and 2 in the intervention districts (case registration rate from 18.2 to 24.2/100 000) and from 97 to 113 in the control districts (13.4 to 15.6/100 000): the increases were significantly higher in the intervention districts compared with the control districts. The increases were also significantly higher in children aged 0–4 years and in those with smear-negative pulmonary TB and extra-pulmonary TB. Of the various case-finding strategies, household contact screening, private-public mix services and mobile health chest camps produced the highest yield of TB.

Conclusion: A package of intensified case-finding strategies in children was associated with an increase in childhood TB case registrations in Nepal. Additional diagnostic approaches to increase case registrations also need to be considered.

Keywords: SORT IT; TB REACH; non-governmental organisation; operational research; paediatric tuberculosis

Document Type: Research Article

Affiliations: 1: Friends Affected and Infected Together In Hand (FAITH), Kathmandu, Nepal 2: Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India 3: National Tuberculosis Centre, Thimi, Bhaktapur, Nepal 4: Médecins Sans Frontières Operational Centre Brussels, New Delhi, India 5: International Union Against Tuberculosis and Lung Disease (The Union), South-East Asian Regional Office, New Delhi, India 6: Sano Paila (A little step), Lalitpur, Nepal 7: World Health Organization Country Office for Nepal, Lalitpur, Nepal 8: The Union, Paris, France, London School of Hygiene & Tropical Medicine, London, UK

Publication date: 21 June 2015

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

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