Human resource requirements for quality-assured electronic data capture of the tuberculosis case register

<p>Abstract</p> <p>Background</p> <p>The tuberculosis case register is the data source for the reports submitted by basic management units to the national tuberculosis program. Our objective was to measure the data entry time required to complete and double-enter one record, and to estimate the time for the correction of errors in the captured information from tuberculosis case registers in Cambodia and Viet Nam. This should assist in quantifying the additional requirements in human resources for national programs moving towards electronic recording and reporting.</p> <p>Methods</p> <p>Data from a representative sample of tuberculosis case registers from Cambodia and Viet Nam were double-entered and discordances resolved by rechecking the original case register. Computer-generated data entry time recorded the time elapsed between opening of a new record and saving it to disk.</p> <p>Results</p> <p>The dataset comprised 22,732 double-entered records of 11,366 patients (37.1% from Cambodia and 62.9% from Viet Nam). The mean data entry times per record were 97.5 (95% CI: 96.2-98.8) and 66.2 (95% CI: 59.5-73.0) seconds with medians of 90 and 31 s respectively in Cambodia and in Viet Nam. The percentage of records with an error was 6.0% and 39.0% respectively in Cambodia and Viet Nam. Data entry time was inversely associated with error frequency. We estimate that approximately 118-person-hours were required to produce 1,000 validated records.</p> <p>Conclusions</p> <p>This study quantifies differences between two countries for data entry time for the tuberculosis case register and frequencies of data entry errors and suggests that higher data entry speed is partially offset by requiring revisiting more records for corrections.</p

Tuberculosis and sexually transmitted infections

To the Editor: Mycobacterium tuberculosis infection is a necessary, but not sufficient, cause of tuberculosis (TB). Infection with HIV is the strongest known risk factor for disease progression to TB. In the absence of HIV infection, disease develops in 5% to 15% of infected persons. Unfortunately, the process of progression to disease is poorly understood. We hypothesize that, in addition to HIV, another sexually transmitted infection (STI) also increases such disease progression. Identification of this STI might suggest new approaches to disease control.Several associations between the risk for TB and lifestyle factors have been identified. [...]<br/

Determination of the Prevalence of Infection with Mycobacterium tuberculosis among Persons Vaccinated against Bacillus Calmette-Guérin in South Korea

The prevalence of tuberculous infection was estimated among 12,032 persons with a Bacillus Calmette-Guérin (BCG) vaccination scar and 7,788 persons without such a scar who participated in a nationwide tuberculin skin test survey conducted in the Republic of Korea in 1975. The analysis was built upon mixture models that captured the heterogeneity of indurations arising from tuberculous infection, cross-reactions due to infection with environmental mycobacteria, and BCG vaccination. The three distributions were allowed to vary by age, sex, and BCG vaccination status in the Bayesian manner, according to the prior opinion of the authors. Estimated prevalences of tuberculous infection were similar among persons with a BCG scar and persons without one: 7.5% (95% credibility interval (CI): 3.1, 12.5) and 5.2% (95% CI: 4.2, 6.3), respectively, at age 0-4 years and 87.3% (95% CI: 84.0, 90.2) and 84.0% (95% CI: 81.9, 85.8), respectively, at age 25-29 years. From this analysis it can be concluded that mixture models allow investigators, for the first time, to estimate the prevalence of tuberculous infection not only in unvaccinated persons but also in the BCG-vaccinated population. Mixture models are a versatile tool for analyzing diagnostic test data and more general classification problems of considerable complexit

Tuberculosis and sexually transmitted infections

To the Editor: Mycobacterium tuberculosis infection is a necessary, but not sufficient, cause of tuberculosis (TB). Infection with HIV is the strongest known risk factor for disease progression to TB. In the absence of HIV infection, disease develops in 5% to 15% of infected persons. Unfortunately, the process of progression to disease is poorly understood. We hypothesize that, in addition to HIV, another sexually transmitted infection (STI) also increases such disease progression. Identification of this STI might suggest new approaches to disease control.Several associations between the risk for TB and lifestyle factors have been identified. [...]<br/

Ein Verarbeitungsmodell für eine modulare Bewertung von Kennzahlenwerten durch den Endanwender

Die Beobachtung und Bewertung des zeitlichen Verlaufes einer Vielzahl von Kennzahlenwerten ist für die Vorbereitung vieler unternehmerischer Entscheidungen unabdinglich. In diesem Tagungsbeitrag wird ein Verarbeitungsmodell zur automatischen "pseudointelligenten" Bewertung von Kennzahlenwerten vorgestellt und dessen Vor- und Nachteile diskutiert. Dieses Verarbeitungsmodell bildet eine Komponente der Implementierungsgrundlage des rechnergestützten wissensbasierten Modellierungssystems "EISREVU" , dessen andere, in diesem Beitrag nicht vorgestellten Komponenten es dem Endanwender erlauben, die Kennzahlen, die bewertet werden, zu modellieren

Operational research in low-income countries: what, why, and how?

Operational research is increasingly being discussed at institutional meetings, donor forums, and scientific conferences, but limited published information exists on its role from a disease-control and programme perspective. We suggest a definition of operational research, clarify its relevance to infectious-disease control programmes, and describe some of the enabling factors and challenges for its integration into programme settings. Particularly in areas where the disease burden is high and resources and time are limited, investment in operational research and promotion of a culture of inquiry are needed so that health care can become more efficient. Thus, research capacity needs to be developed, specific resources allocated, and different stakeholders (academic institutions, national programme managers, and non-governmental organisations) brought together in promoting operational research

A new and reliable culture system for superficial low-grade urothelial carcinoma of the bladder

Several bladder cancer culture systems have been developed in recent years. However, reports about successful primary cultures of superficial urothelial carcinomas (UC) are sparse. Based on the specific growth requirements of UC described previously, we developed a new and reliable culture system for superficial low-grade UC. Between November 2002 and April 2006, 64 primary cultures of bladder cancer specimens were performed. After incubating the specimens overnight in 0.1% ethylenediaminetetraacetic acid solution, tumour cells could easily be separated from the submucosal tissue. Subsequently, cells were seeded in a low-calcium culture medium supplemented with 1% serum, growth factors, non-essential amino acids and glycine. The malignant origin of the cultured cells was demonstrated by spectral karyotyping. Overall culture success rate leading to a homogenous tumour cell population without fibroblast contamination was 63%. Culture success could be remarkably enhanced by the addition of glycine to the culture medium. Interestingly, 86.4% of pTa tumours were cultured successfully compared to only 50% of the pT1 and 38% of advanced stage tumours, respectively. G1 and G2 tumours grew significantly better than G3 tumours (86, 73 and 41%, respectively). Up to three passages of low-grade UC primary cultures were possible. We describe a new and reliable culture system, which is highly successful for primary culture and passage of low-grade UC of the bladder. Therefore, this culture system can widely be used for functional experiments on early stage bladder cance

Tuberculosis and Sexually Transmitted Infections

To the Editor: Mycobacterium tuberculosis infection is a necessary, but not sufficient, cause of tuberculosis (TB). Infection with HIV is the strongest known risk factor for disease progression to TB. In the absence of HIV infection, disease develops in 5% to 15% of infected persons. Unfortunately, the process of progression to disease is poorly understood. We hypothesize that, in addition to HIV, another sexually transmitted infection (STI) also increases such disease progression. Identification of this STI might suggest new approaches to disease control.Several associations between the risk for TB and lifestyle factors have been identified. [...]<br/

Risk of Travel-Associated Tuberculosis

Infection with Mycobacterium tuberculosis might be acquired at home or during travel. The risk is determined by exposure frequency to a source case and the duration of the exposure. Thus, whether travel increases the background risk depends on origin, destination, and duration of travel. Infection might be acquired indoors or outdoors, but the overall risk seems small, whatever the setting. Bacille Calmette-Guérin vaccination and preventive therapy have both been discussed as possible preventive interventions, but the disadvantages associated with both approaches appear to outweigh any benefits. Because the risk of acquisition of infection with M. tuberculosis is small, the most rational approach is likely to delay intervention until a traveler presents with clinically active tuberculosis, as is done with any other patient. The risk of becoming infected with Mycobacterium tuberculosis depends on 2 factors: first, relevant exposure to a source of infection, and second, the probability of becoming infected if there is exposure. Exposure risk is determined by the epidemiologic profile of tuberculosis in the population segment within which one preferentially moves. Tuberculosis incidence varies not only among [1] but also within countries Indoors, tubercle bacilli are expelled into a finite volume of air unless there is ventilation In contrast, tubercle bacilli outdoors are rapidly dispersed and rendered quickly nonviable by sunlight or even sky ligh