Strategies for active detection of tuberculosis in Ukraine: Comparative effectiveness amongst key populations (2014-2018)

  • Natalia Kamenska Alliance for Public Health, Kyiv, Ukraine
  • Dilyara Nabirova US Centers for Disease Control and Prevention, Central Asia Regional Office, Almaty, Kazakhstan
  • Karapet Davtyan TB Research and Prevention Center NGO, Yerevan, Armenia
  • Hayk Davtyan TB Research and Prevention Center NGO, Yerevan, Armenia
  • Rony Zachariah Special Programme for Research and Training in Tropical Diseases, (WHO/TDR), World Health Organization, Geneva, Switzerland
  • Garry Aslanyan Special Programme for Research and Training in Tropical Diseases, (WHO/TDR), World Health Organization, Geneva, Switzerland
Keywords: Tuberculosis, operational research, active tuberculosis case finding, Ukraine, key populations

Abstract

Introduction: Ukraine has gaps in Tuberculosis (TB) service coverage, especially in key populations (KPs). We compared effectiveness of three different strategies for active TB detection among KPs and their linkage to TB treatment during three time periods.

Methodology: The KPs included people who inject drugs (PWID), sex workers (SW), men who have sex with men (MSM) and groups at-risk of TB (ex-prisoners, Roma and homeless). The active case finding included decentralized symptom screening and specimen collection (2014, strategy-1), decentralized screening with patient referred for specimen collection (2015-2017, strategy-2) and strategy-2 plus GeneXpert (2018, strategy-3).

Results: In total 680,760 KPs were screened, of whom 68% were PWID. TB case detection per 100,000 populations was 1,191 in strategy-1, 302 in strategy-2, and 235 in strategy-3. The number needed to screen (NNS) to identify one case was respectively 84, 332, and 425. TB detection was highest among homeless (range: 1,839-2,297 per 100,000 population). The lowest detection was among the MSM and SW. Between 2014 and 2018, 82-94% of all diagnosed TB patients in KPs started TB treatment.

Conclusions: The active case finding in KPs increased detection of TB cases in Ukraine, and the majority of diagnosed KPs initiated TB treatment. Centralization of diagnosis reduced the effectiveness of TB screening. Each region in Ukraine should assess the composition and the needs of KPs which will allow for adoption of specific strategies to detect TB among KPs with high TB prevalence.

Published
2019-07-31
How to Cite
1.
Kamenska N, Nabirova D, Davtyan K, Davtyan H, Zachariah R, Aslanyan G (2019) Strategies for active detection of tuberculosis in Ukraine: Comparative effectiveness amongst key populations (2014-2018). J Infect Dev Ctries 13:89S-94S. doi: 10.3855/jidc.11294
Section
The Ukrainian SORT IT Course