Early diagnosis and treatment of infectious cases of tuberculosis (TB) is the most costeffective strategy for TB control. Case detection and cure rates of new smear positive cases measure the progress of a TB program. The first part of this thesis will analyze factors influencing the performance of the passive case finding process. The TB suspect definition and application and the efficiency of diagnostic procedures in routine conditions will be evaluated. The second part will provide evidence to optimise active case finding strategies. We will study the rate of secondary cases of TB among household contacts infected with the same strain than the index case. We will determine the rate of reinfections and relapses among recurrent episodes of TB as a proxy measure of ongoing transmission in the community. The study will be conducted in an urban district in Lima, Peru that reports 204 new cases of TB per 100,000 inhabitants, 5% of primary multidrug resistant (MDR) TB and 2% prevalence of HIV in TB patients 1,2. Data will be collected through cross sectional and prospective longitudinal studies. Biological samples will be processed at the laboratory of the Instituto de Medicina Tropical Alexander von Humboldt (IMTAVH). The results will lead to recommendations for the Peruvian TB program and also provide a better scientific understanding of factors that negatively influence case finding in high incidence settings with good DOTS coverage and high rates of case detection and treatment cure.
|Effective start/end date||1/02/10 → 20/10/16|
IWETO expertise domain