Mobile targeted screening for tuberculosis in Zimbabwe: diagnosis, linkage to care and treatment outcomes.

SETTING: Targeted active screening for tuberculosis (Tas4TB) using mobile trucks in the community was implemented in 15 high TB burden districts in Zimbabwe. At-risk populations were screened for TB based on symptoms and chest radiography (CXR) results. Those with any positive symptom and/or an abnormal CXR had sputum collected for investigation and diagnosis and were linked to care and treatment if found to have TB. OBJECTIVE: To determine 1) the proportion and characteristics of those screened and diagnosed with TB; 2) the relationship between TB symptoms, CXR and diagnostic yields; and 3) the relationship between initiation of anti-TB treatment and treatment outcomes. DESIGN: Cohort study using routinely collected data. RESULTS: A total of 39 065 persons were screened, of whom 663 (1.7%) were diagnosed with TB; 126/663 (19.0%) were bacteriologically confirmed. The highest TB diagnostic yields were in symptomatic persons with CXRs suggestive of TB (19.4%), asymptomatic persons with CXRs suggestive of TB (8.4%) and persons at high-risk of TB (3.2%). For all diagnosed TB patients, pre-treatment loss to follow-up was 18.9% and treatment success was 59.9%. CONCLUSION: Tas4TB resulted in high diagnostic yields; however, linkage of diagnosis to care was poor. Reasons for loss to follow-up need to be better understood and rectified.

Correlations between weights of newborn babies, placental parameters and gestational age.

The relationships between foetal weights, placental parameters and gestational ages were studied in 200 placentae. In addition to confirming that foetal weight, placental weight and gestational age correlated, the results showed that baby weight, placental weight, placental surface area correlate to the length of cord and that the length of cord correlates to gestational age (p < 0.05). These correlations are reported for the first time and are difficult to explain. It is recommended to establish birthweight standards in order to assess intra-uterine growth retardation, and to re-examine the correlations reported here through prospective studies as they might be relevant clinically and provide important clues on morbidity prospects of an individual during postnatal life.