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Community-based active case finding for tuberculosis in rural western China: a cross-sectional study
1Aeras, Beijing, China, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Summary
Active case finding (ACF) using community-based symptom screening and laboratory tests significantly increased tuberculosis case detection in rural China. This approach is feasible and effective, identifying substantially more cases than passive surveillance.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Global Health
Background:
- Passive case finding strategies are insufficient for identifying tuberculosis (TB) patients in rural China.
- Effective strategies are needed to improve TB case detection in underserved populations.
Purpose of the Study:
- To evaluate a community-based active case finding (ACF) scheme for identifying symptomatic individuals with TB in rural China.
- To assess the feasibility and effectiveness of ACF in increasing TB case detection.
Main Methods:
- Door-to-door household visits screened residents aged ≥15 years for TB symptoms.
- Symptomatic individuals provided sputum samples for microscopy, culture, and Xpert® MTB/RIF testing.
- Chest X-rays were performed on all participants.
Main Results:
- Out of 19,334 residents screened, 865 (4.5%) reported symptoms; 52 TB cases were detected.
- Xpert® MTB/RIF identified all culture-positive cases and three additional diagnoses.
- Prevalence of newly detected TB was 475 and 196 per 100,000 population, significantly higher than passive surveillance.
Conclusions:
- Community-based symptom screening combined with laboratory testing is a feasible and effective strategy for increasing TB case finding in rural China.
- ACF substantially improves upon passive surveillance methods for TB detection in this setting.