Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality: A cluster randomised trial in Indian neonates vaccinated with BCG

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Standard

Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality : A cluster randomised trial in Indian neonates vaccinated with BCG. / Jenum, Synne; Selvam, Sumithra; Jesuraj, Nelson; Ritz, Christian; Hesseling, Anneke C; Cardenas, Vicky; Lau, Esther; Doherty, Mark T; Grewal, Harleen M S; Vaz, Mario; TB Trials Study Group.

I: B M J Open Respiratory Research, Bind 5, Nr. 1, e000304, 2018.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Jenum, S, Selvam, S, Jesuraj, N, Ritz, C, Hesseling, AC, Cardenas, V, Lau, E, Doherty, MT, Grewal, HMS, Vaz, M & TB Trials Study Group 2018, 'Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality: A cluster randomised trial in Indian neonates vaccinated with BCG', B M J Open Respiratory Research, bind 5, nr. 1, e000304. https://doi.org/10.1136/bmjresp-2018-000304

APA

Jenum, S., Selvam, S., Jesuraj, N., Ritz, C., Hesseling, A. C., Cardenas, V., ... TB Trials Study Group (2018). Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality: A cluster randomised trial in Indian neonates vaccinated with BCG. B M J Open Respiratory Research, 5(1), [e000304]. https://doi.org/10.1136/bmjresp-2018-000304

Vancouver

Jenum S, Selvam S, Jesuraj N, Ritz C, Hesseling AC, Cardenas V o.a. Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality: A cluster randomised trial in Indian neonates vaccinated with BCG. B M J Open Respiratory Research. 2018;5(1). e000304. https://doi.org/10.1136/bmjresp-2018-000304

Author

Jenum, Synne ; Selvam, Sumithra ; Jesuraj, Nelson ; Ritz, Christian ; Hesseling, Anneke C ; Cardenas, Vicky ; Lau, Esther ; Doherty, Mark T ; Grewal, Harleen M S ; Vaz, Mario ; TB Trials Study Group. / Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality : A cluster randomised trial in Indian neonates vaccinated with BCG. I: B M J Open Respiratory Research. 2018 ; Bind 5, Nr. 1.

Bibtex

@article{a26a09e26f454a04bafb820c2031122f,
title = "Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality: A cluster randomised trial in Indian neonates vaccinated with BCG",
abstract = "Introduction: Accurate tuberculosis (TB) incidence and optimal surveillance strategies are pertinent to TB vaccine trial design. Infants are a targeted population for new TB vaccines, but data from India, with the highest global burden of TB cases, is limited. Methods: In a population-based prospective trial conducted between November 2006 and July 2008, BCG-vaccinated neonates in South India were enrolled and cluster-randomised to active or passive surveillance. We assessed the influence of surveillance strategy on TB incidence, case-finding rates and all-cause mortality. Predefined criteria were used to diagnose TB. All deaths were evaluated using a verbal autopsy. Results: 4382 children contributed to 8164 person-years (py) of follow-up (loss to follow-up 6.9{\%}); 749 children were admitted for TB evaluation (active surveillance: 641; passive surveillance: 108). The TB incidence was 159.2/100 000 py and the overall case-finding rate was 3.19 per 100 py (95{\%} CI 0.82 to 18.1). Whereas, the case-finding rate for definite TB was similar using active or passive case finding, the case-finding rate for probable TB was 1.92/100 py (95{\%} CI 0.83 to 3.78) with active surveillance, significantly higher than 0.3/100 py (95{\%} CI 0.01 to 1.39, p=0.02) with passive surveillance. Compared to passive surveillance, children with active surveillance had decreased risk of dying (OR 0.68, 95{\%}CI 0.47 to 0.98) which was mostly attributable to reduction of death from pneumonia/respiratory infections (OR 0.34, 95{\%}CI 0.14 to 0.80). Conclusion: We provide reliable estimates of TB incidence in South Indian children <2 years of age. Active surveillance increased the case-finding rates for probable TB and was associated with reduced all-cause mortality.",
keywords = "Clinical epidemiology, Paediatric lung disease, Respiratory infection, Tuberculosis (TB), Infants, India",
author = "Synne Jenum and Sumithra Selvam and Nelson Jesuraj and Christian Ritz and Hesseling, {Anneke C} and Vicky Cardenas and Esther Lau and Doherty, {Mark T} and Grewal, {Harleen M S} and Mario Vaz and {TB Trials Study Group}",
note = "CURIS 2018 NEXS 366",
year = "2018",
doi = "10.1136/bmjresp-2018-000304",
language = "English",
volume = "5",
journal = "B M J Open Respiratory Research",
issn = "2052-4439",
publisher = "B M J Group",
number = "1",

}

RIS

TY - JOUR

T1 - Incidence of tuberculosis and the influence of surveillance strategy on tuberculosis case-finding and all-cause mortality

T2 - A cluster randomised trial in Indian neonates vaccinated with BCG

AU - Jenum, Synne

AU - Selvam, Sumithra

AU - Jesuraj, Nelson

AU - Ritz, Christian

AU - Hesseling, Anneke C

AU - Cardenas, Vicky

AU - Lau, Esther

AU - Doherty, Mark T

AU - Grewal, Harleen M S

AU - Vaz, Mario

AU - TB Trials Study Group

N1 - CURIS 2018 NEXS 366

PY - 2018

Y1 - 2018

N2 - Introduction: Accurate tuberculosis (TB) incidence and optimal surveillance strategies are pertinent to TB vaccine trial design. Infants are a targeted population for new TB vaccines, but data from India, with the highest global burden of TB cases, is limited. Methods: In a population-based prospective trial conducted between November 2006 and July 2008, BCG-vaccinated neonates in South India were enrolled and cluster-randomised to active or passive surveillance. We assessed the influence of surveillance strategy on TB incidence, case-finding rates and all-cause mortality. Predefined criteria were used to diagnose TB. All deaths were evaluated using a verbal autopsy. Results: 4382 children contributed to 8164 person-years (py) of follow-up (loss to follow-up 6.9%); 749 children were admitted for TB evaluation (active surveillance: 641; passive surveillance: 108). The TB incidence was 159.2/100 000 py and the overall case-finding rate was 3.19 per 100 py (95% CI 0.82 to 18.1). Whereas, the case-finding rate for definite TB was similar using active or passive case finding, the case-finding rate for probable TB was 1.92/100 py (95% CI 0.83 to 3.78) with active surveillance, significantly higher than 0.3/100 py (95% CI 0.01 to 1.39, p=0.02) with passive surveillance. Compared to passive surveillance, children with active surveillance had decreased risk of dying (OR 0.68, 95%CI 0.47 to 0.98) which was mostly attributable to reduction of death from pneumonia/respiratory infections (OR 0.34, 95%CI 0.14 to 0.80). Conclusion: We provide reliable estimates of TB incidence in South Indian children <2 years of age. Active surveillance increased the case-finding rates for probable TB and was associated with reduced all-cause mortality.

AB - Introduction: Accurate tuberculosis (TB) incidence and optimal surveillance strategies are pertinent to TB vaccine trial design. Infants are a targeted population for new TB vaccines, but data from India, with the highest global burden of TB cases, is limited. Methods: In a population-based prospective trial conducted between November 2006 and July 2008, BCG-vaccinated neonates in South India were enrolled and cluster-randomised to active or passive surveillance. We assessed the influence of surveillance strategy on TB incidence, case-finding rates and all-cause mortality. Predefined criteria were used to diagnose TB. All deaths were evaluated using a verbal autopsy. Results: 4382 children contributed to 8164 person-years (py) of follow-up (loss to follow-up 6.9%); 749 children were admitted for TB evaluation (active surveillance: 641; passive surveillance: 108). The TB incidence was 159.2/100 000 py and the overall case-finding rate was 3.19 per 100 py (95% CI 0.82 to 18.1). Whereas, the case-finding rate for definite TB was similar using active or passive case finding, the case-finding rate for probable TB was 1.92/100 py (95% CI 0.83 to 3.78) with active surveillance, significantly higher than 0.3/100 py (95% CI 0.01 to 1.39, p=0.02) with passive surveillance. Compared to passive surveillance, children with active surveillance had decreased risk of dying (OR 0.68, 95%CI 0.47 to 0.98) which was mostly attributable to reduction of death from pneumonia/respiratory infections (OR 0.34, 95%CI 0.14 to 0.80). Conclusion: We provide reliable estimates of TB incidence in South Indian children <2 years of age. Active surveillance increased the case-finding rates for probable TB and was associated with reduced all-cause mortality.

KW - Clinical epidemiology

KW - Paediatric lung disease

KW - Respiratory infection

KW - Tuberculosis (TB)

KW - Infants

KW - India

U2 - 10.1136/bmjresp-2018-000304

DO - 10.1136/bmjresp-2018-000304

M3 - Journal article

VL - 5

JO - B M J Open Respiratory Research

JF - B M J Open Respiratory Research

SN - 2052-4439

IS - 1

M1 - e000304

ER -

ID: 204200572