Evidence map›Paper›PMID 37914308›Full record

ArticleBMJ open2023

Quantifying the potential epidemiological impact of a 2-year active case finding for tuberculosis in rural Nepal: a model-based analysis.

Sourya Shrestha, Gokul Mishra, Mukesh Hamal, Raghu Dhital, Suvesh Shrestha, Ashish Shrestha, Naveen Prakash Shah, Mukti Khanal, Suman Gurung, Maxine Caws

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 39% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

10 authors at 3 institutions in 3 countries.

Sourya ShresthaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA sshres14@jh.edu.ORCID 0000-0002-6106-6834
Gokul MishraDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK.
Mukesh HamalDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Raghu DhitalBirat Nepal Medical Trust, Kathmandu, Nepal.
Suvesh ShresthaSave the Children Nepal, Kathmandu, Nepal.
Ashish ShresthaNational Tuberculosis Center, Bhaktapur, Nepal.
Naveen Prakash ShahNational Tuberculosis Center, Bhaktapur, Nepal.
Mukti KhanalNational Tuberculosis Center, Bhaktapur, Nepal.
Suman GurungDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, Liverpool, UK.
Maxine CawsBirat Nepal Medical Trust, Kathmandu, Nepal.
Johns Hopkins University · USLiverpool School of Tropical Medicine · GBBhaktapur Cancer Hospital · NP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesActive case finding (ACF) is an important tuberculosis (TB) intervention in high-burden settings. However, empirical evidence garnered from field data has been equivocal about the long-term community-level impact, and more data at a finer geographic scale and data-informed methods to quantify their impact are necessary.

methodsUsing village development committee (VDC)-level data on TB notification and demography between 2016 and 2017 in four southern districts of Nepal, where ACF activities were implemented as a part of the IMPACT-TB study between 2017 and 2019, we developed VDC-level transmission models of TB and ACF. Using these models and ACF yield data collected in the study, we estimated the potential epidemiological impact of IMPACT-TB ACF and compared its efficiency across VDCs in each district.

resultsCases were found in the majority of VDCs during IMPACT-TB ACF, but the number of cases detected within VDCs correlated weakly with historic case notification rates. We projected that this ACF intervention would reduce the TB incidence rate by 14% (12-16) in Chitwan, 8.6% (7.3-9.7) in Dhanusha, 8.3% (7.3-9.2) in Mahottari and 3% (2.5-3.2) in Makwanpur. Over the next 10 years, we projected that this intervention would avert 987 (746-1282), 422 (304-571), 598 (450-782) and 197 (172-240) cases in Chitwan, Dhanusha, Mahottari and Makwanpur, respectively. There was substantial variation in the efficiency of ACF across VDCs: there was up to twofold difference in the number of cases averted in the 10 years per case detected.

conclusionACF data confirm that TB is widely prevalent, including in VDCs with relatively low reporting rates. Although ACF is a highly efficient component of TB control, its impact can vary substantially at local levels and must be combined with other interventions to alter TB epidemiology significantly.

Indexed as

Mass ScreeningTuberculosisHumansIncidenceNepalEPIDEMIOLOGYPublic healthTuberculosis

Identifiers

PMID37914308
PMCPMC10626874
OpenAlexW4388126518

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.