IngentaConnect Active case finding: understanding the burden of tuberculosis in ...

Authors: Pronyk P. M.¹; Joshi B.¹; Hargreaves J. R.¹; Madonsela T.¹; Collinson M. A.¹; Mokoena O.¹; Tollman S. M.¹; Hausler H. P.²

Source: The International Journal of Tuberculosis and Lung Disease, Volume 5, Number 7, July 2001 , pp. 611-618(8)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: The Agincourt demographic and health surveillance site in South Africa?s rural Northern Province.

OBJECTIVES: To accurately assess the true burden of tuberculosis in a rural sub-district with a known high prevalence of human immunodeficiency virus.

DESIGN: Data on hospital registrations of tuberculosis were combined with data from an ongoing demographic health and surveillance system to accurately describe the burden of tuberculosis in a well-defined community. Undiagnosed active cases of sputum-positive disease in the community were detected among chronic coughers identified by heads of household during a single-pass census interview.

RESULTS: The incidence of hospitalised tuberculosis among the permanently resident population (n = 56566) was 212/100000 person-years during 1999. The average point prevalence of detected tuberculosis (all forms) among patients aged over 10 years was 133/100000, and 81/100000 for sputum-positive pulmonary disease. This compares with a point prevalence of 16/100000 cases of sputum-positive disease detected through active case finding.

CONCLUSION: For every nine cases of sputum positive pulmonary tuberculosis being treated at any one time, there are two cases of undiagnosed disease in the community. This study demonstrates a modest burden of undiagnosed tuberculosis among residents in a rural sub-district in South Africa.

Keywords: tuberculosis; epidemiology; South Africa; active case finding; tuberculosis surveillance

Language: English

Document Type: Regular paper

Affiliations: 1: Department of Community Health, University of the Witwatersrand, Medical School, Parktown, Johannesburg, South Africa 2: Directorate HIV/AIDS and STDs, Department of Health, Pretoria, South Africa

Active case finding: understanding the burden of tuberculosis in rural South Africa