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Increasing TB/HIV Case Notification through an Active Case-Finding Approach among Rural and Mining Communities in

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Active case-finding interventions in Tanzania successfully identified and linked hard-to-reach populations, including miners and female sex workers, to tuberculosis (TB) and HIV services, helping to close the TB treatment coverage gap.

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Global Health

Background:

  • Tanzania faces a high burden of tuberculosis (TB), with a significant gap in diagnosis and notification.
  • The World Health Organization (WHO) aims to end TB by 2030, necessitating innovative strategies to improve case detection.

Purpose of the Study:

  • To assess the effectiveness of a TB REACH active case-finding (ACF) intervention in increasing TB/HIV case notification in rural and mining communities in Northwest Tanzania.
  • To evaluate the linkage to care for marginalized populations, including miners and female sex workers (FSW).

Main Methods:

  • Conducted an ACF intervention from July 2017 to June 2020, offering integrated TB/HIV screening, diagnostics, and referral services.
  • Targeted rural and mining communities, including evening "Moonlight Events" for accessibility.
  • Screened 144,707 people for TB, with 24,200 tested for TB and 4,478 for HIV.

Main Results:

  • Diagnosed 1,499 people with TB and 1,273 people with HIV, including 154 with TB/HIV coinfection.
  • Demonstrated that community-based ACF effectively links hard-to-reach populations to TB care.
  • Evening integrated services successfully identified individuals with undiagnosed TB and HIV in mining settlements.

Conclusions:

  • Community-based ACF interventions are crucial for bridging the TB treatment coverage gap in high-burden countries.
  • Integrated TB/HIV outreach services, particularly in mining areas, can significantly improve health outcomes for marginalized groups.
  • Local NGOs play a vital role in connecting vulnerable populations to public health services for improved TB and HIV management.