Abstract
BackgroundThe WHO recommends that individuals exposed to persons with multidrug resistant tuberculosis (MDRTB) should be screened for active TB and followed up for 2 years to detect and treat secondary cases early. Resource prioritisation means this is rarely undertaken and where it is performed it’s usually using a paper-based record, without collation of data. Electronic data collection into a web-based registry offers the opportunity for simplified and systematic TB contact surveillance with automatic synthesis of data at local, regional and national level. This pilot study was designed to explore the feasibility of usage of a novel e-registry tool and explore obstacles and facilitating factors to implementation.MethodsIn parallel with their paper records, seven dispensaries in Ulaanbaatar, Mongolia collected standardized data electronically using Open Data Kit (ODK). Patients with MDRTB and their contacts were recruited during a single clinic visit. Staff and patients were interviewed to gain insights into acceptability and to identify areas for improvement.ResultsSeventy household contacts of 32 MDR-TB index patients were recruited. 7/70 contacts (10%) traced had active TB at the time they were recruited to the e-registry.Paper registry satisfaction was low; 88% of staff preferred the e-registry as it was perceived as faster and more secure. Patients and their contacts were generally supportive of the e-registry; however, a significant minority 10/42 (24%) of index cases who were invited, declined to participate in the e-registry, with data security cited as their top concern.ConclusionE-registries are a promising tool for MDRTB contact tracing, but their acceptability amongst patients should not be taken for granted.
Highlights
The World Health Organization (WHO) recommends that individuals exposed to persons with multidrug resistant tuberculosis (MDRTB) should be screened for active TB and followed up for 2 years to detect and treat secondary cases early
In this study we aimed to evaluate the feasibility of a novel mobile electronic data collection tool for the building of a web-based MDRTB contact e-registry, and we collected descriptive epidemiological data on contacts
MDRTB contact tracing in Ulaanbaatar 32 of 42 invited index patients with laboratory confirmed MDRTB agreed to participate in electronic registration of themselves and their contacts
Summary
The WHO recommends that individuals exposed to persons with multidrug resistant tuberculosis (MDRTB) should be screened for active TB and followed up for 2 years to detect and treat secondary cases early. Resource prioritisation means this is rarely undertaken and where it is performed it’s usually using a paper-based record, without collation of data. Electronic data collection into a web-based registry offers the opportunity for simplified and systematic TB contact surveillance with automatic synthesis of data at local, regional and national level This pilot study was designed to explore the feasibility of usage of a novel e-registry tool and explore obstacles and facilitating factors to implementation. Whilst the WHO guidelines include precise definitions of index cases, close contacts and household contacts [5, 16, 17], a minimum dataset for an MDRTB contact registry has yet to be internationally agreed [9, 18] and no agency currently provides support in the form of data collection tools through which such a dataset could be uniformly collected, aggregated, analysed and disseminated
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