Author:
Lin Ching-Hsiung,Tsai Cheng-Hung,Liu Chun-Eng,Huang Mei-Li,Chang Shu-Chen,Wen Jen-Ho,Chai Woei-Horng
Abstract
Abstract
Background
Current tuberculosis (TB) reporting protocols are insufficient to achieve the goals established by the Stop TB partnership. Some countries have recommended implementation of active case finding program. We assessed the effect of Cough Officer Screening (an active screening system) on the rate of TB detection and health care system delays over the course of four years.
Methods
Patients who were hospitalized at the Changhua Christian Hospital (Changhua, Taiwan) were enrolled from September 2004 to July 2006 (Stage I) and August 2006 to August 2008 (Stage II). Stage II was implemented after a Plan-Do-Check-Act (PDCA) cycle analysis indicated that we should exclude ICU and paediatric patients.
Results
In Stage I, our COS system alerted physicians to 19,836 patients, and 7,998 were examined. 184 of these 7,998 patients (2.3%) had TB. Among these 184 patients, 142 (77.2%) were examined for TB before COS alarming and 42 were diagnosed after COS alarming. In Stage II, a total of 11,323 patients were alerted by the COS system. Among them, 6,221 patients were examined by physicians, and 125 of these patients (2.0%) had TB. Among these 125 patients, 113 (90.4%) were examined for TB before COS alarming and 12 were diagnosed after COS alarming. The median time from COS alarm to clinical action was significantly less (p = 0.041) for Stage I (1 day; range: 0-16 days) than for Stage II (2 days; range: 0-10 days).
Conclusion
Our COS system improves detection of TB by reducing the delay from infection to diagnosis. Modifications of scope may be needed to improve cost-effectiveness.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference22 articles.
1. Raviglione MC, Uplekar MW: WHO's new Stop TB Strategy. Lancet. 2006, 367: 952-955. 10.1016/S0140-6736(06)68392-X.
2. World Health Organization: Global tuberculosis control: Surveillance, planning, financing. WHO Report 2002. 2002, Geneva, Switzerland: WHO
3. Baltussen R, Floyd K, Dye C: Cost effectiveness analysis of strategies for tuberculosis control in developing countries. BMJ. 2005, 331: 1364-10.1136/bmj.38645.660093.68.
4. den Boon S, Verver S, Lombard CJ, Bateman ED, Irusen EM, Enarson DA, Borgdorff MW, Beyers N: Comparison of symptoms and treatment outcomes between actively and passively detected tuberculosis cases: the additional value of active case finding. Epidemiol Infect. 2008, 136: 1342-1349. 10.1017/S0950268807000106. Epub 2008 Jan 4, 2009.
5. Golub JE, Mohan CI, Comstock GW, Chaisson RE: Active case finding of tuberculosis: historical perspective and future prospects. Int J Tuberc Lung Dis. 2005, 9: 1183-1203.
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