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dc.contributor.authorJenum, Synneen_US
dc.contributor.authorSumithra, Selvamen_US
dc.contributor.authorNelson, Jesurajen_US
dc.contributor.authorChristian, Ritzen_US
dc.contributor.authorHesseling Anneke, Cen_US
dc.contributor.authorVicky, Cardenasen_US
dc.contributor.authorEsther, Lauen_US
dc.contributor.authorMark, Doherty Ten_US
dc.contributor.authorGrewal, Harleenen_US
dc.contributor.authorMario, Vazen_US
dc.date.accessioned2019-05-29T11:51:34Z
dc.date.available2019-05-29T11:51:34Z
dc.date.issued2019
dc.PublishedJenum S, Sumithra, Nelson, Christian, Hesseling Anneke, Vicky, Esther, Mark, Grewal H, Mario. 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. BMJ Open Respiratory Research. 2018;5:e000304eng
dc.identifier.issn2052-4439
dc.identifier.urihttps://hdl.handle.net/1956/19812
dc.description.abstractIntroduction: 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.en_US
dc.language.isoengeng
dc.publisherBMJeng
dc.rightsAttribution CC BY-NCeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/eng
dc.titleIncidence 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 BCGen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2019-01-24T09:13:51Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2018 The Author(s)
dc.identifier.doihttps://doi.org/10.1136/bmjresp-2018-000304
dc.identifier.cristin1641483
dc.source.journalBMJ Open Respiratory Research


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