Tuberculosis Clinical Trial
Official title:
Achieving TB Control In Zambia Through Scale Up Of Innovative Tools And Proven Active TB Case Finding Interventions
To achieve TB control, innovative case finding interventions are needed that will reach the broader affected population including those that do not access the health facilities. Systematic community case finding with highly sensitive screening and diagnostic tools are needed. At the facility level, the index of suspicion for TB by health care workers needs to be raised to ensure that all those that need TB screening are appropriately screened.
The purpose of this study is to initiate sustained, active health facility and
community-based case finding interventions to achieve improved TB case detection in high
burden settings (Zambia) and contribute to TB control.
The interventions are expected to increase the impact of Xpert on TB case finding, thus
increase TB case detection through scaling up of a combination of community level and
facility level TB case finding interventions. The study will generate evidence on the added
value of using Chest X-ray (CXR) screening at community level, whilst also comparing the
performance of CXR with computer assisted diagnosis (CAD) and C-reactive protein (CRP) and
symptoms as screening tools in terms sensitivity, specificity and cost effectiveness. Symptom
screen alone has been shown to be suboptimal for screening as it misses a significant
percentage of TB due to atypical presentation of TB in HIV-infected populations.
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