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Estimating tuberculosis case detection rate in resource-limited countries: a capture-recapture study in Egypt
A Bassili1, A D Grant, E El-Mohgazy
1Stop TB Unit, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt. bassilia@emro.who.int
Summary
This study estimated tuberculosis (TB) case detection rates in Egypt using record linkage and capture-recapture analysis. The findings highlight the need for improved national TB surveillance systems, especially in resource-limited settings.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Surveillance
Background:
- Reliable tuberculosis (TB) surveillance systems are lacking in many endemic countries.
- Indirect estimation of TB incidence is crucial for monitoring National Tuberculosis Programmes (NTPs) and achieving global TB control targets.
Purpose of the Study:
- To estimate the case detection rate (CDR) for all TB cases and sputum smear-positive TB cases in Egypt in 2007.
- To assess the completeness of case ascertainment through record linkage and capture-recapture analysis.
Main Methods:
- Utilized record linkage and three-source capture-recapture analysis.
- Employed active prospective longitudinal surveillance in public and private non-NTP sectors.
- Data collected from four Egyptian governorates selected via stratified cluster random sampling.
Main Results:
- Estimated CDR for all TB cases by NTP surveillance was 55% (95% CI 46-68), with completeness after record linkage at 62% (95% CI 52-77).
- For sputum smear-positive TB cases, estimated CDR was 66% (95% CI 55-75), and completeness was 72% (95% CI 60-82).
Conclusions:
- Pilot study demonstrates that combining representative sampling, non-NTP sector surveillance, record linkage, and capture-recapture analysis can enhance CDR estimation.
- Further development of this methodology is needed for standardized global application.
- Resource-limited countries must prioritize strengthening national TB surveillance systems aligned with the Stop TB strategy.
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