Title
A role for community-level socioeconomic indicators in targeting tuberculosis screening interventions
Date Issued
01 December 2022
Access level
open access
Resource Type
journal article
Author(s)
Brooks M.B.
Jenkins H.E.
Puma D.
Tzelios C.
Millones A.K.
Galea J.T.
Becerra M.C.
Keshavjee S.
Yuen C.M.
Publisher(s)
Nature Research
Abstract
Tuberculosis screening programs commonly target areas with high case notification rates. However, this may exacerbate disparities by excluding areas that already face barriers to accessing diagnostic services. We compared historic case notification rates, demographic, and socioeconomic indicators as predictors of neighborhood-level tuberculosis screening yield during a mobile screening program in 74 neighborhoods in Lima, Peru. We used logistic regression and Classification and Regression Tree (CART) analysis to identify predictors of screening yield. During February 7, 2019āFebruary 6, 2020, the program screened 29,619 people and diagnosed 147 tuberculosis cases. Historic case notification rate was not associated with screening yield in any analysis. In regression analysis, screening yield decreased as the percent of vehicle ownership increased (odds ratio [OR]: 0.76 per 10% increase in vehicle ownership; 95% confidence interval [CI]: 0.58ā0.99). CART analysis identified the percent of blender ownership (⤠83.1% vs > 83.1%; OR: 1.7; 95% CI: 1.2ā2.6) and the percent of TB patients with a prior tuberculosis episode (> 10.6% vs ⤠10.6%; OR: 3.6; 95% CI: 1.0ā12.7) as optimal predictors of screening yield. Overall, socioeconomic indicators were better predictors of tuberculosis screening yield than historic case notification rates. Considering community-level socioeconomic characteristics could help identify high-yield locations for screening interventions.
Volume
12
Issue
1
Language
English
OCDE Knowledge area
GeografĆa económica y cultural
Enfermedades infecciosas
Sistema respiratorio
Scopus EID
2-s2.0-85123091650
PubMed ID
Source
Scientific Reports
ISSN of the container
20452322
Sponsor(s)
This work was supported by the National Institutes of Health [Grant Number 1DP2MD015102] to CMY and the Harvard Medical School Center for Global Health Delivery. The original screening program was funded by the Harvard Medical School Center for Global Health Delivery and grants from TB REACH and Johnson and Johnson Global Public Health. Collection of geospatial data for historic cases was supported by grants from the Cassell Family Fund, Johnson and Johnson Global Public Health, and the Harvard Medical School Center for Global Health Delivery. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.
Sources of information:
Directorio de Producción CientĆfica
Scopus