Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India

Introduction Sputum smear microscopy is the cornerstone of tuberculosis (TB) diagnosis under the Revised National Tuberculosis Control Programme (RNTCP) in India. Instructions on how to produce a good sputum sample are a part of RNTCP training manuals, but its assessment is not emphasised. Healthcar...

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Main Authors: Siddharudha Shivalli, Amrut Hondappagol, Kibballi Madhukeshwar Akshaya, Abhay Nirgude, Narendra Varun, Raveendra Harohally Ramaiah Reddy, Burugina Nagaraja Sharath
Format: Article
Language:English
Published: BMJ Publishing Group 2020-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/3/e032991.full
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author Siddharudha Shivalli
Amrut Hondappagol
Kibballi Madhukeshwar Akshaya
Abhay Nirgude
Narendra Varun
Raveendra Harohally Ramaiah Reddy
Burugina Nagaraja Sharath
author_facet Siddharudha Shivalli
Amrut Hondappagol
Kibballi Madhukeshwar Akshaya
Abhay Nirgude
Narendra Varun
Raveendra Harohally Ramaiah Reddy
Burugina Nagaraja Sharath
author_sort Siddharudha Shivalli
collection DOAJ
description Introduction Sputum smear microscopy is the cornerstone of tuberculosis (TB) diagnosis under the Revised National Tuberculosis Control Programme (RNTCP) in India. Instructions on how to produce a good sputum sample are a part of RNTCP training manuals, but its assessment is not emphasised. Healthcare provider’s instruction to expectorate a good sputum sample has limitations. Presumptive TB patients often submit inadequate (in quantity and/or quality) sputum samples, which may result in false-negative results. Objectives of the study are, among the selected RNTCP designated microscopy centres in Dakshina Kannada district, Karnataka, India, (a) to assess the effectiveness of mobile phone instructional video demonstrating sputum expectoration on sputum quality and quantity and (b) to explore the mobile phone video implementation challenges as perceived by the healthcare providers.Methods and analysis This is a pragmatic, prospective, non-randomised controlled trial in two pairs of RNTCP Designated Microscopy Centres (located at secondary and primary healthcare facilities) of Dakshina Kannada district, India. Presumptive pulmonary TB patients aged ≥18 years will be included. We will exclude who are severely ill, blind, hearing impaired, patients who have already brought their sputum for examination, and transported sputum. In the intervention group, participants will watch a mobile phone instructional video demonstrating submission of an adequate sputum sample. The control group will follow the usual ongoing procedure for sputum submission. This study would require 406 participants for each group to achieve a power of 90% for detecting a difference of 15% between the two groups. The participant enrolment started in December 2019.Ethics and dissemination Yenepoya University Ethics Committee, Mangaluru, India, has approved the study protocol (YEC-1/158/2019). It complies with the Declaration of Helsinki, local laws, and the International Council for Harmonization-good clinical practices. Investigators will present the results in scientific forums, publish in a scientific journal, and share with RNTCP officers.Trial registration number Clinical Trial Registry of India (CTRI/2019/06/019887).
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spelling doaj-art-2b770d9755c642b5a57b52f02ed27ea32025-08-20T02:19:44ZengBMJ Publishing GroupBMJ Open2044-60552020-03-0110310.1136/bmjopen-2019-032991Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, IndiaSiddharudha Shivalli0Amrut Hondappagol1Kibballi Madhukeshwar Akshaya2Abhay Nirgude3Narendra Varun4Raveendra Harohally Ramaiah Reddy5Burugina Nagaraja Sharath6Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UKDepartment of Public Health, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, IndiaDepartment of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, IndiaDepartment of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, IndiaDepartment of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru, IndiaDepartment of Community Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IndiaESIC Medical College and PGIMSR, Bengaluru-560010, Karnataka, IndiaIntroduction Sputum smear microscopy is the cornerstone of tuberculosis (TB) diagnosis under the Revised National Tuberculosis Control Programme (RNTCP) in India. Instructions on how to produce a good sputum sample are a part of RNTCP training manuals, but its assessment is not emphasised. Healthcare provider’s instruction to expectorate a good sputum sample has limitations. Presumptive TB patients often submit inadequate (in quantity and/or quality) sputum samples, which may result in false-negative results. Objectives of the study are, among the selected RNTCP designated microscopy centres in Dakshina Kannada district, Karnataka, India, (a) to assess the effectiveness of mobile phone instructional video demonstrating sputum expectoration on sputum quality and quantity and (b) to explore the mobile phone video implementation challenges as perceived by the healthcare providers.Methods and analysis This is a pragmatic, prospective, non-randomised controlled trial in two pairs of RNTCP Designated Microscopy Centres (located at secondary and primary healthcare facilities) of Dakshina Kannada district, India. Presumptive pulmonary TB patients aged ≥18 years will be included. We will exclude who are severely ill, blind, hearing impaired, patients who have already brought their sputum for examination, and transported sputum. In the intervention group, participants will watch a mobile phone instructional video demonstrating submission of an adequate sputum sample. The control group will follow the usual ongoing procedure for sputum submission. This study would require 406 participants for each group to achieve a power of 90% for detecting a difference of 15% between the two groups. The participant enrolment started in December 2019.Ethics and dissemination Yenepoya University Ethics Committee, Mangaluru, India, has approved the study protocol (YEC-1/158/2019). It complies with the Declaration of Helsinki, local laws, and the International Council for Harmonization-good clinical practices. Investigators will present the results in scientific forums, publish in a scientific journal, and share with RNTCP officers.Trial registration number Clinical Trial Registry of India (CTRI/2019/06/019887).https://bmjopen.bmj.com/content/10/3/e032991.full
spellingShingle Siddharudha Shivalli
Amrut Hondappagol
Kibballi Madhukeshwar Akshaya
Abhay Nirgude
Narendra Varun
Raveendra Harohally Ramaiah Reddy
Burugina Nagaraja Sharath
Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India
BMJ Open
title Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India
title_full Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India
title_fullStr Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India
title_full_unstemmed Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India
title_short Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India
title_sort does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary tb cases protocol for a prospective pragmatic non randomised controlled trial in karnataka state india
url https://bmjopen.bmj.com/content/10/3/e032991.full
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