Asymptomatic Screening of Clients on Opioid Substitution Therapy for Tuberculosis: An Experience from India

Banuru Muralidhara Prasad,Mandeep Singh,Rajeev Kumar,Parmesh C Bhatnagar,Pruthu Thekkur,Sarabjit Singh Chadha,Mukesh Gupta

doi:10.4236/jtr.2019.73012

Banuru Muralidhara Prasad, Mandeep Singh + Show 5 more

Open Access

https://doi.org/10.4236/jtr.2019.73012

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Abstract

Clients on Opioid Substitution Therapy (OST) may be at risk of TB. We screened for tuberculosis in asymptomatic OST clients using Chest-X-ray (CXR) and sputum from those with CXR suggestive of TB were tested using Xpert MTB/Rif. Among 472 who underwent CXR, 1% had CXR suggestive of TB. The number needed to screen was 118 clients for one CXR suggestive of TB. All four clients with CXR suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB. The TB patient was asymptomatic and could have been missed through the passive approach. We recommend further studies to explore ACF among OST clients.

Highlights

All four clients with chest X-ray (CXR) suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB
National Strategic Plan 2017-25 (NSP) of India, in line with global strategy proposes to have focused interventions expanding the definitions of vulnerable populations to End-TB by 2025 [1]
A private digital chest X-ray (CXR) with radiologist was engaged within 2 KMs from the centre who offered CXR to all Opioid Substitution Therapy (OST) clients attending the centre during July 2016

Summary

Introduction

All four clients with CXR suggestive of TB underwent MTB/Rif assay and one was diagnosed with TB. We recommend further studies to explore ACF among OST clients. OST, Tuberculosis, Active Case Finding, Screening, Chest X-Ray Limited evidence suggests that clients on opioids may be considered as vulnerable population for developing

Results

Conclusion