Publications by authors named "Lisanne Gerstel"

This study aimed to estimate the costs and incremental cost-effectiveness of two community-based tuberculosis (TB) active case-finding (ACF) strategies in Cambodia. We also assessed the number needed to screen and test to find one TB case. Program and national TB notification data from a quasi-experimental study of a cohort of people with TB in 12 intervention operational districts (ODs) and 12 control ODs between November 2018 and December 2019 were analyzed.

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Background: Cambodia has one of the highest tuberculosis (TB) prevalence rates in the world. People aged 55 years and over account for an estimated 50% of the country's TB burden, yet this group has a low notification rate owing to specific barriers in accessing health services. One-off active case finding (ACF) days with mobile GeneXpert and X-ray systems were organized at 75 government health facilities in four operational districts.

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Article Synopsis
  • The study evaluated different active case finding (ACF) strategies for diagnosing all forms of tuberculosis (TB) in Cambodia, focusing on clients with varying levels of risk.
  • Clients were divided into high-risk and moderate-risk groups, with diagnostic methods including sputum tests and chest X-rays, which significantly increased same-day diagnosis rates.
  • The findings showed that X-ray combined with Xpert testing was the most effective approach, especially for high-risk individuals, suggesting that X-rays should be a key part of TB diagnostic strategies.
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The authors describe an adapted method, originally developed for infectious disease resource allocation, for prioritizing infectious diseases for inclusion in a Pacific island nation's National Notifiable Diseases List. Using a process that was systematic, transparent, objective, and addressed multiple criteria, a panel of stakeholders judged candidate diseases against 12 objective criteria and arrived at weighted scores for the diseases, which were then ranked. The result was the successful creation of a list of 22 urgently notifiable conditions.

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