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New TB screening approach yields good result

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A patient and a family member sit on a bed at the National Centre for Tuberculosis and Leprosy Control in Chamkarmon district, Phnom Penh, in 2013. Heng Chivoan

New TB screening approach yields good result

Research into a new approach to tuberculosis screening has yielded promising results after a trial run amongst Phnom Penh’s urban poor, according to a new paper released on Friday.

The method – called the “active case finding strategy” – involves health workers visiting people in their homes and collecting samples of mucus and saliva to test for cases of TB preemptively.

“We were able to detect TB cases among the urban poor, who have far less access to health care,” said the author of the research, PhD student Natalie Lorent of the Institute of Tropical Medicine, Antwerp.

“Untreated patients may die of the disease but they may also infect others around them. It is therefore important to find and treat new cases as soon as possible.”

TB is a leading cause of death in Cambodia, and according to the World Health Organization 2014 global tuberculosis report, almost 40,000 cases of TB were identified in the Kingdom in 2013, the most recent year for which WHO figures are available.

Preemptive screening and early diagnosis is especially important because, as Lorent notes in her report, as many as a third of all TB cases worldwide go undiagnosed.

According to the report, Lorent and her colleagues from Sihanouk Hospital Centre of Hope (SHCH), with whom she collaborated in carrying out the research, went door to door in poor urban settlements of Phnom Penh, where they diagnosed 783 TB cases.

New diagnostic tests, not previously available in Cambodia, and the use of mobile phones for instant communication, allowed swift referral and treatment of patients. Results from the trial were encouraging.

“Overall 95% began TB treatment and 81% obtained a successful treatment outcome; less than 3% failed to start treatment,” the report says.

Dr. Mao Tan Eang, director for the National Centre for Tuberculosis and Leprosy Control, maintained yesterday that Cambodia has been making strong progress in general in the struggle against the disease.

“The problem of TB in Cambodia is getting smaller and smaller,” he said. “In 2014 we identified 43,000 cases, which occur in all age groups, but for the last 10 years, the prevalence of TB has declined on average by 6.5 per cent every year.”

Eang put this success down to the adoption of a way of delivering medication to patients known as DOTS (Directly Observed Therapy – Short Course) which involves health workers and volunteers visiting sick individuals on a daily basis to ensure they take their medication.

“People need to take medication for six to eight months, and before we introduced the DOTS approach, they sometimes would stop taking their medicine a few weeks into treatment because they started feeling better,” he said.

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