Investigator(s)
| Submitter |
Karchung Tshering Royal Centers for Disease Control, Ministry of Health Karchung Tshering 
|
| Principal Investigator |
Karchung Tshering Royal Centers for Disease Control, Ministry of Health Karchung Tshering
|
| Co-Investigator(s) |
Tshokey N/A Lab, Jigme Dorji Wangchuck National Referral Hospital Tshokey N/A
|
| Co-Investigator(s) |
Nidup N/A Department of Radiology, Jigme Dorji Wangchuck National Referral Hospital Nidup N/A
|
| Co-Investigator(s) |
Tashi Gyeltshen Department of Radiology, Jigme Dorji Wangchuck National Referral Hospital Tashi Gyeltshen
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| Co-Investigator(s) |
Tshering Jamtsho Medical Education Centre for Research Innovation and Technology, Khesar Gyalpo University of Medical Sciences of Bhutan Tshering Jamtsho
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| Co-Investigator(s) |
Rada Dukpa National Tuberculosis Control Program, Communicable Disease Division, Department of Public Health, Ministry of Health Rada Dukpa
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| Co-Investigator(s) |
Sonam Tshoki Lhamu Royal Centers for Disease Control, Ministry of Health Sonam Tshoki Lhamu
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| Co-Investigator(s) |
Pavitra Bhujel Royal Centers for Disease Control, Ministry of Health Pavitra Bhujel
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| Co-Investigator(s) |
Sherab Zangmo Royal Centers for Disease Control, Ministry of Health Sherab Zangmo
|
| Co-Investigator(s) |
Tshering Dolkar Royal Centers for Disease Control, Ministry of Health Tshering Dolkar
|
Title(s) and abstract
| Scientific title | Tuberculosis screening in asymptomatic community populations, an effective case detection strategy: Insights from VISA medical screening process in Bhutan |
| Public title | Tuberculosis screening in asymptomatic community populations, an effective case detection strategy: Insights from VISA medical screening process in Bhutan |
| Background | Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a significant public health issue in Bhutan, impacting morbidity, mortality, and socioeconomic development. Geographic and socioeconomic challenges, coupled with international travel, exacerbate TB transmission risks. Effective control requires early detection and treatment, especially among vulnerable groups like international travelers. Bhutan’s visa medical screening, aligned with requirements from countries like Australia and Canada, offers a chance to enhance TB detection. The e-Medical process includes medical history reviews, physical exams, chest X-rays, and sputum cultures. Positive cases must undergo treatment per national guidelines before visa processing. Chest X-rays and TB cultures are vital for detecting active TB, but no comprehensive studies in Bhutan evaluate their effectiveness or predictive value. In 2020, Bhutan-born individuals ranked fifth in TB cases reported by Western Australia. Inadequate screening risks stricter travel requirements, limiting opportunities for Bhutanese travelers. This study aims to assess TB culture and chest X-ray efficacy in e-Medical screening, provide policy recommendations, and improve TB control, safeguarding public health and international mobility. |
| Objectives | This study will be carried out with the following objectives: To determine the positive attributes and effectiveness of TB culture complemented by chest X-ray in TB case detection during e-medical screening in Bhutan. To assess the demographic and clinical characteristics of the affected population, to identify risk factors associated with TB. |
| Study Methods | Study Design- This study will be a retrospective descriptive cross sectional study. Study period and sample size- The study will describe retrospective data from the year 2018 to 2023 (five years). There will be no definite calculated sample size but all individuals fulfilling the inclusion criteria for the study period will be included and analyzed. Data collection-The process of data collection includes the retrieval of relevant information from VISA screening records at the JDWNRH, CRRH, ERRH and RCDC.Standardized data collection forms will be used (designed using Epidata tool). Data Analysis- Descriptive analysis of demographic characteristics of the TB cases will be done. Univariate and multivariate logistic regression analysis will be done to look at the association between X-ray abnormalities and the outcome of the TB diagnosis. Data will be analyses using R version 4.2.0 / STATA. |
| Expected outcomes and use of results | The study will identify the characteristics of TB cases amongst individuals attending medical examinations for visa. This will help us to identify TB in apparently healthy individuals and guide us in deciding the next steps towards TB screening in healthy individuals as part of the National TB program. |
| Keywords | Tuberculosis (TB), TB screening, Chest X-ray (CXR), Sputum culture, e-Medical process, Public health concern, Pulmonary tuberculosis, Active case detection, International travelers,National TB program |
Research Details
| Student research | No |
| Start Date | 01-Nov-2024 |
| End Date | 31-May-2025 |
| Key Implementing Institution | Royal Centre for Disease Control |
| Multi-country research | No |
| Nationwide research | No |
| Bhutan | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Tuberculosis |
| Involves human subjects | Yes |
| Other (Retrospective Study) | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |