Evidence map›Paper›PMID 32787869›Full record

ArticleBMC infectious diseases2020

Reducing delays to multidrug-resistant tuberculosis case detection through a revised routine surveillance system.

Basra Esmail Doulla, Stephen Bertel Squire, Eleanor MacPherson, Esther Stanslaus Ngadaya, Beatrice Kemilembe Mutayoba, Ivor Langley

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.0field-weighted citation impact, top 60% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Basra Esmail DoullaMinistry of Health, Community Development, Gender, Elderly and Children; National Tuberculosis and Leprosy Programme, Dar es Salaam, Tanzania. bedoulla@gmail.com.
Stephen Bertel SquireLiverpool School of Tropical Medicine, Centre for Applied Health Research and Delivery, Liverpool, UK.
Eleanor MacPhersonLiverpool School of Tropical Medicine, Centre for Applied Health Research and Delivery, Liverpool, UK.
Esther Stanslaus NgadayaNational Institutes for Medical Research, Muhimbili Medical Research Centre, Dar es Salaam, Tanzania.
Beatrice Kemilembe MutayobaMinistry of Health, Community Development, Gender, Elderly and Children; National Tuberculosis and Leprosy Programme, Dar es Salaam, Tanzania.
Ivor LangleyLiverpool School of Tropical Medicine, Centre for Applied Health Research and Delivery, Liverpool, UK.
Liverpool School of Tropical Medicine · GBMinistry of Health and Social Welfare · TZMinistry of Health, Community Development, Gender, Elderly and Children · TZNational Institute for Medical Research · TZ

Funding

Swiss Tropical and Public Health Institute 201007629
6 · The paper itself

Abstract

backgroundImplementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilities to reference laboratory and results dissemination back to the health facilities, result in poor patient management, particularly where multidrug-resistant tuberculosis disease is present.

methodsFollowing a detailed qualitative study, a pilot intervention of a revised Tuberculosis Routine Surveillance System was implemented in Mwanza region, Tanzania. This included the use of rapid molecular methods for the detection of both tuberculosis and drug resistance using Xpert MTB/RIF in some Mwanza sites, the use of Xpert MTB/RIF and Line Probe Assay at the Central Tuberculosis Reference Laboratory, a revised communication strategy and interventions to address the issue of poor form completion. A before and after comparison of the intervention on the number of drug resistant tuberculosis cases identified and the time taken for results feedback to the requesting site was reported.

resultsThe revised system for previously treated cases tested at the Central Reference Laboratory was able to obtain the following findings; the number of cases tested increased from 75 in 2016 to 185 in 2017. The times for specimen transportation from health facilities to the reference laboratory were reduced by 22% (from 9 to 7 days). The median time for the district to receive results was reduced by 36% (from 11 to 7 days). Overall the number of drug resistant tuberculosis cases starting treatment increased by 67% (from 12 to 20).

conclusionDetection of drug resistance could significantly be enhanced, and delays reduced by introduction of new technologies and improved routine surveillance system, including better communication using mobile applications such as 'WhatsApp' and close follow-ups. A larger scale study is now merited to ascertain if these benefits are robust across different contexts.

Indexed as

Epidemiological MonitoringAntibiotics, AntitubercularCommunicationDelayed DiagnosisDiagnostic Tests, RoutineDrug Resistance, Multiple, BacterialHealth FacilitiesHumansLaboratoriesMycobacterium tuberculosisNucleic Acid Amplification TechniquesPilot ProjectsProspective StudiesQualitative ResearchRifampinSpecimen HandlingAntibiotics, AntitubercularRifampinPreviously treated casesReference laboratoryRoutine surveillance systemSpecimensTuberculosis

Identifiers

PMID32787869
PMCPMC7425571
OpenAlexW3048435098

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.