{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:57:06Z","timestamp":1784372226432,"version":"3.55.0"},"reference-count":55,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Qiagen","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Stop TB Partnership","award":["STBP\/TBREACH\/GSA\/W6SU-09"],"award-info":[{"award-number":["STBP\/TBREACH\/GSA\/W6SU-09"]}]},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["733174"],"award-info":[{"award-number":["733174"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000023","name":"Government of Canada","doi-asserted-by":"publisher","award":["CA-3-D000920001"],"award-info":[{"award-number":["CA-3-D000920001"]}],"id":[{"id":"10.13039\/501100000023","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,1,24]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To end tuberculosis (TB), the vast reservoir of 1.7\u20132.3\u2009billion TB infections (TBIs) must be addressed, but achieving global TB preventive therapy (TPT) targets seems unlikely. This study assessed the feasibility of using interferon-\u03b3 release assays (IGRAs) at lower healthcare levels and the comparative performance of 3-month and 9-month daily TPT regimens (3HR\/9H).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants and intervention<\/jats:title>\n                    <jats:p>This cohort study was implemented in two provinces of Viet Nam from May 2019 to September 2020. Participants included household contacts (HHCs), vulnerable community members and healthcare workers (HCWs) recruited at community-based TB screening events or HHC investigations at primary care centres, who were followed up throughout TPT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>We constructed TBI care cascades describing indeterminate and positivity rates to assess feasibility, and initiation and completion rates to assess performance. We fitted mixed-effects logistic and stratified Cox models to identify factors associated with IGRA positivity and loss to follow-up (LTFU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5837 participants, the indeterminate rate was 0.8%, and 30.7% were IGRA positive. TPT initiation and completion rates were 63.3% (3HR=61.2%\u2009vs 9H=63.6%; p=0.147) and 80.6% (3HR=85.7%\u2009vs 9H=80.0%; p=0.522), respectively. Being male (adjusted OR=1.51; 95% CI: 1.28 to 1.78; p&lt;0.001), aged 45\u201359 years (1.30; 1.05 to 1.60; p=0.018) and exhibiting TB-related abnormalities on X-ray (2.23; 1.38 to 3.61; p=0.001) were associated with positive IGRA results. Risk of IGRA positivity was lower in periurban districts (0.55; 0.36 to 0.85; p=0.007), aged &lt;15 years (0.18; 0.13 to 0.26; p&lt;0.001), aged 15\u201329 years (0.56; 0.42 to 0.75; p&lt;0.001) and HCWs (0.34; 0.24 to 0.48; p&lt;0.001). The 3HR regimen (adjusted HR=3.83; 1.49 to 9.84; p=0.005) and HCWs (1.38; 1.25 to 1.53; p&lt;0.001) showed higher hazards of LTFU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Providing IGRAs at lower healthcare levels is feasible and along with shorter regimens may expand access and uptake towards meeting TPT targets, but scale-up may require complementary advocacy and education for beneficiaries and providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-071537","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T10:05:54Z","timestamp":1675937154000},"page":"e071537","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Optimising diagnosis and treatment of tuberculosis infection in community and primary care settings in two urban provinces of Viet Nam: a cohort study"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct02073240","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5937-6286","authenticated-orcid":false,"given":"Luan Nguyen Quang","family":"Vo","sequence":"first","affiliation":[{"name":"Friends for International TB Relief, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viet Nhung","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National TB Programme, National Lung Hospital, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nga Thi Thuy","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Friends for International TB Relief, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy Thi Thu","family":"Dong","sequence":"additional","affiliation":[{"name":"Friends for International TB Relief, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Codlin","sequence":"additional","affiliation":[{"name":"Friends for International TB Relief, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Forse","sequence":"additional","affiliation":[{"name":"TB Programs, Friends for International TB Relief, Ho Chi Minh City, Viet Nam"},{"name":"Department of Global Public Health, The Health and Social Protection Action Research & Knowledge Sharing network (SPARKS), Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huyen Thanh","family":"Truong","sequence":"additional","affiliation":[{"name":"National Lung Hospital, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoa Binh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National Lung Hospital, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Thi Minh","family":"Dang","sequence":"additional","affiliation":[{"name":"Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinh Van","family":"Truong","sequence":"additional","affiliation":[{"name":"Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan Huu","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuan Huy","family":"Mac","sequence":"additional","affiliation":[{"name":"Hai Phong Lung Hospital, Hai Phong, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phong Thanh","family":"Le","sequence":"additional","affiliation":[{"name":"IRD VN Social Enterprise, Ho Chi Minh City, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoa Tu","family":"Tran","sequence":"additional","affiliation":[{"name":"Friends for International TB Relief, Ha Noi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nduku","family":"Ndunda","sequence":"additional","affiliation":[{"name":"Consultant, Dubai, UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxine","family":"Caws","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK"},{"name":"Birat Nepal Medical Trust, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Creswell","sequence":"additional","affiliation":[{"name":"Stop TB Partnership, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"2025120618553823000_13.2.e071537.1","unstructured":"World Health Organization . 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