{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T02:51:12Z","timestamp":1793933472589,"version":"4.8.0"},"reference-count":32,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"unspecified","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/igo\/"}],"funder":[{"name":"Special Programme for Research and Training in Tropical Diseases (TDR) of the World Health Organization","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2024,11,21]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Tuberculosis (TB) poses a significant public health challenge in Guinea, with an estimated 22 000 TB cases in 2020; an estimated 6125 (28%) cases went undetected. We evaluated an intensified TB case finding strategy in Guinea which targeted customers who bought cough suppressants from pharmacies or drug outlets.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We involved 25 pharmacies and 25 drug outlets in Matoto, Conakry, Guinea. Pharmacists or outlet owners identified and referred all customers with TB symptoms who were purchasing cough suppressants to healthcare workers for sputum collection either at the pharmacy or drug outlet or at a nearby TB diagnosis and treatment centre (CDT); sputum was subjected to bacteriological testing with acid fast bacilli smear or Xpert MTB\/RIF. We assessed factors associated with eventual TB diagnosis using logistic regression and time to TB diagnosis using cox regression and used microcosting to estimate the cost of the intervention in 2020 US$.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From November 2019 to June 2020, we screened 916 people referred from pharmacies or drug outlets with TB symptoms, with median age of 31 years (54% male). Overall, 126 (14%) had bacteriologically confirmed TB. Odds of TB diagnosis were significantly lower with increasing age (adjusted OR (aOR) per additional year=0.98; 95% CI 0.97 to 0.99) and higher among males (aOR=1.57; 95% CI 1.04 to 2.39) and those with symptoms. Those identified at drug outlets had significantly faster time to presentation from symptom onset than pharmacies (adjusted HR=1.73; 95% CI 1.50 to 1.99). The total cost of the intervention per person referred was US$32.66 and per person diagnosed and treated for TB disease of US$237.45.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Intensified TB case finding through pharmacies and drug outlets is a feasible and effective way to increase TB detection in settings where self-medicating is common, and TB is under-detected.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2024-002334","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T10:15:27Z","timestamp":1735640127000},"page":"e002334","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Tuberculosis screening among cough suppressant buyers in pharmacies and drug outlets in Guinea: a cross-sectional study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1651-8723","authenticated-orcid":false,"given":"Aboubacar Sidiki","family":"Magassouba","sequence":"first","affiliation":[{"name":"Republic of Guinea Ministry of Health, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-5667","authenticated-orcid":false,"given":"Almamy Amara","family":"Toure","sequence":"additional","affiliation":[{"name":"Gamal Abdel Nasser University of Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boubacar Djelo","family":"Diallo","sequence":"additional","affiliation":[{"name":"National Tuberculosis Program, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gnoume","family":"Camara","sequence":"additional","affiliation":[{"name":"Centre National de Formation et de Recherche en Sant\u00e9 Rurale de Maf\u00e9rinyah, Maferinyah, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desire Lucien","family":"Dahourou","sequence":"additional","affiliation":[{"name":"Institut de Recherche en Sciences de la Sant\u00e9, Ouagadougou, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly Badara","family":"Nabe","sequence":"additional","affiliation":[{"name":"Gamal Abdel Nasser University of Conakry, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souleymane","family":"Camara","sequence":"additional","affiliation":[{"name":"National Tuberculosis Program, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adama Marie","family":"Bangoura","sequence":"additional","affiliation":[{"name":"National Tuberculosis Program, Conakry, Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues Asken","family":"Traore","sequence":"additional","affiliation":[{"name":"World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2341-2166","authenticated-orcid":false,"given":"Jonathon R","family":"Campbell","sequence":"additional","affiliation":[{"name":"McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Veronese","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne Simone Collette","family":"Merle","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"2025083112391395000_11.1.e002334.1","unstructured":"NTP . Annual report of tuberculosis control activities. Guinea: NTP; 2023."},{"key":"2025083112391395000_11.1.e002334.2","unstructured":"WHO . Global tuberculosis report. 2022. Available: http:\/\/www.who.int\/tb\/publications\/global_report\/en\/"},{"key":"2025083112391395000_11.1.e002334.3","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.4.16141"},{"key":"2025083112391395000_11.1.e002334.4","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/1975931","article-title":"Diagnostic Errors in Tuberculous Patients: A Multicenter Study from a Developing Country","volume":"2018","author":"Neshati","year":"2018","journal-title":"J Environ Public Health"},{"key":"2025083112391395000_11.1.e002334.5","unstructured":"WHO . WHO end TB strategy. 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Politique pharmaceutique nationale. 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Council of Europe Convention on the counterfeiting of medical products and similar crimes involving threats to public health (CETS no.211). 2016."},{"key":"2025083112391395000_11.1.e002334.18","doi-asserted-by":"crossref","DOI":"10.1186\/s40249-017-0276-4","article-title":"Diagnostic delay and associated factors among patients with pulmonary tuberculosis in Dar es Salaam, Tanzania","volume":"6","author":"Said","year":"2017","journal-title":"Infect Dis Poverty"},{"key":"2025083112391395000_11.1.e002334.19","first-page":"399","article-title":"Profil clinique des personnes atteintes de la tuberculose \u00e0 Dschang au Cameroun: r\u00f4le des itin\u00e9raires th\u00e9rapeutiques dans le retard au diagnostic","volume":"28","author":"Fran\u00e7ois Roger","year":"2019","journal-title":"Med Sante Trop"},{"key":"2025083112391395000_11.1.e002334.20","first-page":"44","article-title":"Facteurs associes au retard de diagnostic de la tuberculose dans la banlieue dakaroise (S\u00e9n\u00e9gal)","volume":"4","author":"Leye","year":"2017","journal-title":"Rev Afr Malg Rech Sci Sant\u00e9"},{"key":"2025083112391395000_11.1.e002334.21","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofz184","article-title":"Host Determinants of Infectiousness in Smear-Positive Patients With Pulmonary Tuberculosis","volume":"6","author":"Acu\u00f1a-Villaordu\u00f1a","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"2025083112391395000_11.1.e002334.22","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.14.0798"},{"key":"2025083112391395000_11.1.e002334.23","doi-asserted-by":"crossref","DOI":"10.3390\/tropicalmed7090237","article-title":"Delays in TB Diagnosis and Treatment Initiation in Burkina Faso during the COVID-19 Pandemic","volume":"7","author":"Diallo","year":"2022","journal-title":"Trop Med Infect Dis"},{"key":"2025083112391395000_11.1.e002334.24","first-page":"34","article-title":"La situation des soins de sant\u00e9 primaires en France","volume":"15","author":"Gay","year":"2019","journal-title":"M\u00e9d"},{"key":"2025083112391395000_11.1.e002334.25","doi-asserted-by":"crossref","DOI":"10.26633\/RPSP.2020.96","article-title":"Monitoring access barriers to health services in the Americas: a mapping of household surveys","volume":"44","author":"Houghton","year":"2020","journal-title":"Rev Panam Salud Publica"},{"key":"2025083112391395000_11.1.e002334.26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2019-001417","article-title":"Can community pharmacists improve tuberculosis case finding? 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Standardized framework for evaluating costs of active case-finding programs: An analysis of two programs in Cambodia and Tajikistan. 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