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Pulmonary tuberculosis case detection through fortuitous cough screening during home visits
Edilberto González-Ochoa1, Jorge L Brooks, Francine Matthys
1Research and Surveillance Group on TB, Leprosy and ARI, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba. ochoa@ipk.sld.cu
Tropical Medicine & International Health : TM & IH
|February 25, 2009
Summary
Active tuberculosis case finding during home visits significantly boosts detection rates compared to traditional methods. This approach identifies more cases, especially in high-risk populations and those with persistent coughs.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Tuberculosis Control
Background:
- Passive tuberculosis (TB) detection at health services has limitations in case identification.
- Targeted screening strategies are needed to improve TB case detection rates.
Purpose of the Study:
- To compare the effectiveness of active tuberculosis case detection among at-risk groups during home visits versus passive detection at health services.
- To evaluate the yield of active screening in different risk strata.
Main Methods:
- Implemented active screening for TB symptoms (coughing) among family members during home visits.
- Initially screened all family members, then restricted to high-risk groups.
- Compared detection rates with historical passive detection data.
Main Results:
- Overall TB detection increased from 6.7 to 26.2 per 100,000 inhabitants with active case finding.
- Active screening in risk groups detected 35 TB cases per 1000 screened, versus 20 per 1000 for passive screening.
- Screening individuals with a cough for 3+ weeks yielded 107 TB cases per 1000 screened.
Conclusions:
- Active case finding during home visits enhances population-level TB detection.
- This strategy successfully identifies cases missed by passive detection at health facilities.
- Targeting at-risk groups and prolonged cough symptoms improves screening efficiency.
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