* If you want to update the article please login/register
WHO released LTBI guidelines in 2018 as part of WHO's efforts to determine our active TB, but CXR services are not widely available in some settings, and if available, the cost for a CXR often falls on patients and is often prohibitively costly. Objectives: To compare results from three different programs for the care of HIV-infected individuals aged 5 to 50 years who are HH contacts of newly diagnosed microbiologically confirmed active pulmonary TB. This will be a cluster-randomized trial with three arms of equal size; clusters will be identified as all the household contacts of patients with newly diagnosed active pulmonary TB. Participants will be randomly assigned to one of three different study arms: Symptom screening and tuberculin skin testing will be performed. If CXR normal or if microbiological testing negative, TST positives receive latent TB infection therapy. Outcomes: Primary Outcome: Of those eligible for LTBI therapy, the majority of participants will be monitored until LTBI therapy is complete. Prevalence of microbiologically confirmed and clinically diagnosed active TB - found as part of the initial contact investigation, who initiate LTBI therapy within three months of the index TB patient initiating active TB therapy. In patients who are unable to obtain a sputum sample, there is a prevalence of active TB diagnosed using CXR. Statistical analyses: Primary results: The primary outcome is the percentage of people eligible for latent TB therapy who start LTBI therapy. The expected prevalence of HIV-infected HH contacts aged 5 years and older in the two arm groups will be estimated from an age-specific prevalence of positive TST among HH contacts tested in the other two arm groups. Treatment starting will be determined as being given a prescription for LTBI therapy or not dispensed the first month of pills required for LTBI therapy. The proportion of patients starting LTBI therapy within 3 months of the index TB patient starting active TB therapy will be compared in each experimental arm against the normal arm. For each of the strategies, cost estimates for each of the strategies will be determined using all relevant cost components and an ingredients analysis. Based on average salaries from data obtained by facility administration in each case, health care staff time will be valued. The prevalence of microbiologically confirmed and clinically diagnosed active TB will be determined in the first contact investigation, which includes the introduction of LTBI therapy within three months of the index TB patient's beginning active TB therapy, will be compared between the three arms. The proportion of participants completing treatment in each experimental arm against the average arm will be compared. Active TB, which is the treatment of active TB, was only revealed as a result of the CXR's action in people who were unable to obtain a sputum sample.
Source link: https://clinicaltrials.gov/ct2/show/NCT04528823
Primary Goals: The primary aim will be to demonstrate the adequacy of radiology completing a real time review of radiation oncology therapy plans within 4 business days of the date of CT simulation. As a result of these changes, patients who are radiation therapy are changed are patients with radiation therapy as a result of this process, measure absolute and percentage change in the gross tumor volume, clinical target volume, and planning target volume as a result. Determine whether acute esophagitis incidence increased in our entire sample as a result of this investigation during diagnosis and within four weeks following therapy, compared to institutional control databases of patients without formal radiology examination. Determine whether tumor responses at 4 weeks post-treatment differs in our entire sample versus to institutional historical control databases of patients treated without formal radiology review.
Source link: https://clinicaltrials.gov/ct2/show/NCT04844736
Given the increase in the use of CT imaging and the variability in radiation exposure between similar imaging techniques, it is imperative to investigate ways of standardizing and reducing radiation levels from CT imaging. That little is known about CT technologists' attitudes and how they can influence patient radiation exposure, and patients' radiation exposure, so this initiative will also provide us with the opportunity to interview the technologists and see if there is a correlation between technologist attitudes and awareness as well as patient radiation exposure.
Source link: https://clinicaltrials.gov/ct2/show/NCT01405066
Tuberculosis is now the most common cause of death in several African countries. Approximately 40% of the TB epidemic burden in sub-Saharan Africa remains undiagnosed within the community, and 30 percent of such cases are microscopically smear-positive. Hence, primary care and community-based case finding should be a vital component of TB control. The investigators cracked the deadlock of rapid POC diagnosis in Cape Town and Harare's peri-urban'slums' by using a generator and a mini-truck. The investigators then devised a scalable model based on portable battery-operated Xpert Edge, which was installed within a low-cost 15000 Nissan panel van manned by two health care workers. Is CAD mixed with Xpert cost-effective, and can it reduce Xpert usage without losing unacceptable number of TB cases? The investigators will therefore determine the use of CAD as a triage device to help optimize the XACT model. In the forthcoming report, Xpert POC TB testing and x-rays for CAD will be conducted, providing a unique and quick way to screen for both diseases as appropriate. The XACT-19 research findings, in summary, will have major implications for public health policy and practice, and may include the establishment of a new ACF for TB in tandem, as well as COVID-19 in tandem.
Source link: https://clinicaltrials.gov/ct2/show/NCT05220163
* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions