Population-wide active case finding and prevention for tuberculosis and leprosy elimination in Kiribati: the PEARL study protocol

Population-wide active case finding and prevention for tuberculosis and leprosy elimination in Kiribati: the PEARL study protocol.

Full text not available from this repository.
Item Type: Article
Status: Published
Official URL: https://doi.org/10.1136/bmjopen-2021-055295
Journal or Publication Title: BMJ Open
Volume: 12
Number: 4
Page Range: e055295
Date: 12 April 2022
Divisions: Tuberculosis
Depositing User: General Admin
Identification Number: 10.1136/bmjopen-2021-055295
ISSN: 2044-6055
Date Deposited: 26 Sep 2022 00:18

Introduction: Population-wide interventions offer a pathway to tuberculosis (TB) and leprosy elimination, but 'real-world' implementation in a high-burden setting using a combined approach has not been demonstrated. This implementation study aims to demonstrate the feasibility and evaluate the effect of population-wide screening, treatment and prevention on TB and leprosy incidence rates, as well as TB transmission.

Methods and analysis: A non-randomised 'screen-and-treat' intervention conducted in the Pacific atoll of South Tarawa, Kiribati. Households are enumerated and all residents ≥3 years, as well as children <3 years with recent household exposure to TB or leprosy, invited for screening. Participants are screened using tuberculin skin testing, signs and symptoms of TB or leprosy, digital chest X-ray with computer-aided detection and sputum testing (Xpert MTB/RIF Ultra). Those diagnosed with disease are referred to the National TB and Leprosy Programme for management. Participants with TB infection are offered TB preventive treatment and those without TB disease or infection, or leprosy, are offered leprosy prophylaxis. The primary study outcome is the difference in the annual TB case notification rate before and after the intervention; a similar outcome is included for leprosy. The effect on TB transmission will be measured by comparing the estimated annual risk of TB infection in primary school children before and after the intervention, as a co-primary outcome used for power calculations. Comparison of TB and leprosy case notification rates in South Tarawa (the intervention group) and the rest of Kiribati (the control group) before, during and after the intervention is a secondary outcome.

Ethics and dissemination: Approval was obtained from the University of Sydney Human Research Ethics Committee (project no. 2021/127) and the Kiribati Ministry of Health and Medical Services (MHMS). Findings will be shared with the MHMS and local communities, published in peer-reviewed journals and presented at international conferences.

Keywords: EPIDEMIOLOGY; Epidemiology; Infection control; PREVENTIVE MEDICINE; Public health; Tuberculosis.

Coleman, Mikaela
Hill, Jeremy
Timeon, Eretii
Tonganibeia, Alfred
Eromanga, Baraniko
Islam, Tauhid
Trauer, James M
Chambers, Stephen T
Christensen, Amanda
Fox, Greg J
Marks, Guy B
Britton, Warwick J
Marais, Ben J
Last Modified: 26 Sep 2022 00:18
URI: https://eprints.centenary.org.au/id/eprint/1262

Actions (login required)

View Item View Item