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Free Content Increasing tuberculosis case detection through intensive referral and tracing in Hunan, China

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OBJECTIVE: To explore a feasible approach to increase case finding of tuberculosis (TB) through intensive referral and tracing of TB suspects and patients.

METHODS: A quasi-experimental study was conducted in three Chinese cities. A strategic referral and tracing system was developed for the local situation in Hunan, China. Data from a 1-year monitoring of referral, tracing and diagnosis of TB suspects/cases were used to assess outcomes.

RESULTS: Among 126 public general hospitals and clinics in 38 project counties, the 124 (98.4%) health facilities that participated referred an average of 10 TB suspects and cases to the TB dispensary every month. A total of 6364 suspects and 5759 cases were referred. Compared to the previous year, the number of TB suspects increased by 102.1%, from 25 719 to 51 967; the referral of TB suspects increased five-fold; 10 596 new smear-positive pulmonary tuberculosis (PTB) cases were identified; and the notification of new smear-positive PTB increased by 112.9%, from 27.1/100 000 before the project year to 57.7/100 000, a significantly higher percentage than that of non-project areas, which had a notification rate of 38.8/100 000.

CONCLUSION: Intensive referral and tracing of TB suspects/patients is a feasible and effective method of increasing case finding. Strengthening administrative interventions and incentives is essential to achieve project objectives.
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Keywords: case finding; prevention; pulmonary; referral; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Social Medicine, School of Public Health, Central South University, Changsha, China; Hunan Institute of Tuberculosis, Changsha, China 2: Hunan Institute of Tuberculosis, Changsha, China 3: Department of Disease Control, Hunan Provincial Health Bureau, Changsha, China 4: National Centre for Tuberculosis Control and Prevention, Beijing, China 5: Department of Social Medicine, School of Public Health, Central South University, Changsha, China

Publication date: 2008-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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