Additional file 1 of Risk factors for SARS-CoV-2 transmission in student residences: a case-ascertained study

Additional file 1: S1. Statistical analysis – secondary attack rate. Supplementary 2. Sensitivity analysis. Supplementary Figure 1. Timing of outbreaks in student residences. Supplementary Figure 2. Google mobility data between October 30th 2020 and May 25st 2021 for the region of Flemish Brabant, Belgium

Additional file 2 of Risk factors for SARS-CoV-2 transmission in student residences: a case-ascertained study

Additional file 2

Prediction of Under-Detection of Paediatric Tuberculosis in the Democratic Republic of Congo: Experience of Six Years in the South-Kivu Province

<div><p>Introduction</p><p>In the field of tuberculosis (TB), and particularly in regard to paediatric TB (PedTB), clinical skills of health professionals play an important role in determining quality of care. In an era where novel diagnostic technologies and efficient treatment regimens are being made available for the poorest, we must not divert our attention from the importance of clinical skills, as this deliverable remains the cornerstone of individualized patient care and ultimately the best assurance for optimal use of resources. The aim of our work was to study the epidemiology of PedTB and the determinants of PedTB under-detection in the South-Kivu Province of the Democratic Republic of Congo (DRC), a setting with nearly no technical resources allowing to support the clinical diagnosis of PedTB, i.e. chest X-rays, rapid molecular tests or culture laboratories.</p><p>Methods</p><p>We collected TB notification data from 2010 to 2015 and analysed the space-time variations in notification for the different forms of TB among the 113 health facilities (HF) the South-Kivu Province, a region with a low HIV incidence. The different forms of TB notified were: smear positive pulmonary TB (SS+PTB), smear negative pulmonary TB (SS-PTB) and extra-pulmonary TB (EPTB). We further analysed the distribution of these different forms of the disease per age group and explored the possibility to predict the detection of PedTB.</p><p>Results</p><p>Significant differences were observed between HF in regard to the proportion of paediatric TB and the proportion of SS-TB among adults. We found a strong correlation between the proportion of PedTB and three major factors: the proportion of TB cases with no bacteriological confirmation (SS-TB) among adults, the number of TB cases notified by the HF and the fact that the HF was supported or not by Médecins Sans Frontières (MSF). The proportion of SS-TB among adults was found to be a valid indicator for predicting the level of detection of PedTB at the same HF.</p><p>Conclusion</p><p>Our observations strongly suggest that under-detection of PedTB is associated with insufficient clinical skills and technical resources at the HF level which similarly affects other forms of the disease, in particular SS-TB. We demonstrated that, in the specific context of South-Kivu, under-detection of PedTB can be predicted by a low SS-TB/SS+PTB ratio in the adult population. In the context of severely under-resourced settings, this ratio could be used to rapidly identify HF that should benefit in priority from deeper evaluation, and eventually targeted interventions.</p></div

Application of the model predicting under-detection of PedTB at the HF level based on 3 informations: percentage of SS-TB among adults, external support received by MSF and the total number of TB cases notified by the HF during the year.

<p>Application of the model predicting under-detection of PedTB at the HF level based on 3 informations: percentage of SS-TB among adults, external support received by MSF and the total number of TB cases notified by the HF during the year.</p

Correlation between the percentage of PedTB and the percentage of SS-TB among adults.

<p>Circles represent the number of TB cases notified for each Health Facility (HF) during one year (6 years are represented). A strong correlation (p<0.000001) was found between the proportion of SS-TB among adults and the proportion of PedTB.</p

Key changes between 2021 and 2014 TPPs for peripheral TB drug-susceptibility testing.

Key changes between 2021 and 2014 TPPs for peripheral TB drug-susceptibility testing.</p