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Original Articles
Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults
Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han
Epidemiol Health. 2024;46:e2024008.   Published online December 11, 2023
DOI: https://doi.org/10.4178/epih.e2024008
  • 1,008 View
  • 132 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to establish the validity—specifically, the sensitivity and specificity—of the screening questionnaire and diagnostic criteria for oral frailty proposed by the Korean Academy of Geriatric Dentistry (KAGD) among community-dwelling older adults.
METHODS
This study enrolled 100 participants. Among various definitions of oral frailty, this study used the criteria proposed by Tanaka as the reference test. The screening questionnaire consisted of 11 items for screening physical frailty, chewing ability, swallowing difficulties, oral dryness, and tongue and lip motor function. Each question had a different scoring weight, and if the total score was 1 or higher, an oral frailty diagnostic examination proposed by the KAGD would be recommended. The diagnostic test was the oral frailty diagnostic criteria proposed by the KAGD including 6 measures: chewing ability, occlusal force, tongue pressure, oral dryness, swallowing difficulty, and oral hygiene. If a participant exhibited 2 or more positive measures, this participant was classified as “oral frail.” The screening questionnaire was analyzed using a cut-off value of 1 or higher, while the diagnostic criteria utilized a cut-off of 2 or more positive measures. Sensitivity and specificity were calculated.
RESULTS
The screening questionnaire showed significant power for screening oral frailty (area under the receiver operating characteristic curve, 0.783; sensitivity, 87.8%; specificity, 52.5%). The diagnostic accuracy of the newly proposed diagnostic criteria was acceptable (sensitivity, 95.1%; specificity, 42.4%).
CONCLUSIONS
The newly proposed screening questionnaire and diagnostic criteria in Korea appear to be a useful tool to identify oral frailty in community-dwelling older adults.
Summary
Korean summary
본 연구는 지역사회에 거주하는 노인들의 구강 노쇠에 대한 선별검사 설문지와 진단 기준을 검증하는 것을 목표로 했습니다. 민감도와 특이도가 계산되었으며, 스크리닝 설문지는 구강 노쇠를 식별하는 데 상당한 힘을 보여주었고(민감도 87.8%, 특이도 52.5%), 진단 기준은 수용 가능한 정확도(민감도 95.1%, 특이도 42.4%)를 나타냈습니다. 연구 결과는 제안된 선별 설문지와 진단 기준이 한국 지역사회에 거주하는 노인들의 구강 노쇠를 식별하는 데 유용한 도구임을 시사합니다.
The probability of diagnostic delays for tuberculosis and its associated risk factors in northwest Iran from 2005 to 2016: a survival analysis using tuberculosis surveillance data
Reza Ebrahimoghli, Hassan Ghobadi, Davoud Adham, Parviz Jangi, Abbas Abbasi-Ghahramanloo, Eslam Moradi-Asl
Epidemiol Health. 2022;44:e2022060.   Published online July 18, 2022
DOI: https://doi.org/10.4178/epih.e2022060
  • 6,363 View
  • 265 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Early diagnosis is essential for effective tuberculosis (TB) control programs. Therefore, this study examined the risk of delays in TB diagnosis and associated factors in Ardabil Province in northwest Iran from 2005 to 2016.
METHODS
This longitudinal retrospective cohort study was conducted using data obtained from the Iranian National Tuberculosis Control Program at the provincial level between 2005 and 2016. The total delay in diagnosis was defined as the time interval (days) between the onset of symptoms and TB diagnosis. Survival analysis was conducted to analyze the delay in diagnosis. Associated factors were identified using a Cox proportional hazards model.
RESULTS
A total of 1,367 new TB cases were identified. The 12-year median diagnostic delay was 45 days (interquartile range [IQR], 30-87). The annual median diagnostic delay decreased from 68 days (IQR, 33-131) in 2005 to 31 days (IQR, 30-62) in 2016. The probability of a delay in TB diagnosis decreased by 5.0% each year (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.04 to 1.07). Residence in a non-capital county (HR, 0.83; 95% CI, 0.74 to 0.92) and referral from the private health system (HR, 0.74%; 95% CI, 0.65 to 0.84) were significantly associated with an increased risk of delay in TB diagnosis over the 12-year study period.
CONCLUSIONS
The median delay decreased during the study period. We identified factors associated with a longer delay in TB diagnosis. These findings may be useful for further TB control plans and policies in Iran.
Summary
Key Message
A longitudinal analysis of tuberculosis surveillance data from northwest Iran showed that during the 12-year period from 2005 to 2016, a total of 1,367 tuberculosis cases were registered, of whom 942 patients had a prolonged diagnostic delay (>30 days) and the probability of a delay in tuberculosis diagnosis decreased by 5.0% each year.

Citations

Citations to this article as recorded by  
  • Assessing heterogeneity of patient and health system delay among TB in a population with internal migrants in China
    Ruoyao Sun, Zheyuan Wu, Hongyin Zhang, Jinrong Huang, Yueting Liu, Meiru Chen, Yixiao Lv, Fei Zhao, Yangyi Zhang, Minjuan Li, Jiaqi Yan, Hongbing Jiang, Yiqiang Zhan, Jimin Xu, Yanzi Xu, Jianhui Yuan, Yang Zhao, Xin Shen, Chongguang Yang
    Frontiers in Public Health.2024;[Epub]     CrossRef
Perspective
Controlling the drug-resistant tuberculosis epidemic in India: challenges and implications
Aliabbas A. Husain, Andreas Kupz, Rajpal S. Kashyap
Epidemiol Health. 2021;43:e2021022.   Published online April 7, 2021
DOI: https://doi.org/10.4178/epih.e2021022
  • 11,965 View
  • 422 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
India has a higher tuberculosis (TB) burden than any other country, accounting for an estimated one-fourth of the global burden. Drug-resistant tuberculosis (DR-TB) presents a major public health problem in India. Patients with DR-TB often require profound changes in their drug regimens, which are invariably linked to poor treatment adherence and sub-optimal treatment outcomes compared to drug-sensitive TB. The challenge of addressing DR-TB is critical for India, as India contributes over 27% of global DR-TB cases. In recent decades, India has been proactive in its battle against TB, even implementing a revised National Strategic Plan to eliminate TB by 2025. However, to achieve this ambitious goal, the country will need to take a multifaceted approach with respect to its management of DR-TB. Despite concerted efforts made by the National TB Elimination Program, India faces substantial challenges with regard to DR-TB care, especially in peripheral and resource-limited endemic zones. This article describes some of the major challenges associated with mitigating the growing DR-TB epidemic in India and their implications.
Summary
Key Message
India is regarded as highest drug-resistant TB burden country accounting for estimated 27% of global cases. Challenge of addressing drug resistant TB is critical for India to achieve TB elimination targets of National TB program. Several heterogeneous factors have mediated the success of DR-TB management in India. In this article, we discuss, in brief, some of the major challenges and implications associated with reducing the growing DR-TB epidemic in India.

Citations

Citations to this article as recorded by  
  • Rifampicin-resistant Tuberculosis: A Global Health Dilemma
    Rahnuma Ahmad, Susmita Sinha, Kona Chowdhury, Mainul Haque
    Advances in Human Biology.2024; 14(2): 87.     CrossRef
  • Whole-genome sequencing of clinical isolates from tuberculosis patients in India: real-world data indicates a high proportion of pre-XDR cases
    Aparna Bhanushali, Sachin Atre, Preethi Nair, Geethanjali Anilkumar Thandaseery, Sanchi Shah, Sanjana Kuruwa, Amrutraj Zade, Chaitali Nikam, Mangala Gomare, Anirvan Chatterjee, Arryn Craney
    Microbiology Spectrum.2024;[Epub]     CrossRef
  • Double trouble: compounding effects of COVID-19 pandemic and antimicrobial resistance on drug resistant TB epidemiology in India
    Aliabbas A. Husain, Rajpal Singh Kashyap
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Snapshot of Mycobacterium tuberculosis Phylogenetics from an Indian State of Arunachal Pradesh Bordering China
    Shiv kumar Rashmi Mudliar, Umay Kulsum, Syed Beenish Rufai, Mika Umpo, Moi Nyori, Sarman Singh
    Genes.2022; 13(2): 263.     CrossRef
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