Tuberculosis case finding: evaluation of a paper slip method to trace contacts

Area of Science:

• Public Health
• Infectious Disease Control
• Epidemiology

Background:

• South Africa faces a high global burden of tuberculosis (TB).
• Intensified case finding is a key strategy recommended by the World Health Organization (WHO) for TB control.
• Effective contact tracing is crucial for interrupting TB transmission.

Purpose of the Study:

• To assess the effectiveness of a novel paper slip method for tuberculosis contact tracing.
• To evaluate the acceptability of this paper slip method among TB patients.
• To determine the TB case detection rate achieved through this intervention.

Main Methods:

• Tuberculosis patients were provided with paper slips to distribute to their contacts, encouraging TB screening.
• Contact tracing rates, case detection rates, and screening times were calculated.
• Patient interviews and focus group discussions (FGDs) were conducted to gauge method acceptability.

Main Results:

• A 26% tuberculosis contact tracing rate was observed from 718 paper slips issued.
• The case detection rate among traced contacts was 12%.
• The paper slip method demonstrated high acceptability (98%) and was found to be potentially stigma-reducing for TB/HIV.

Conclusions:

• The paper slip method is a simple, inexpensive, and effective tool for tuberculosis contact tracing and case finding.
• This intervention yields high tracing and detection rates, with potential benefits extending beyond household contacts.
• The method's high acceptability suggests feasibility for widespread implementation in high TB burden settings.