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Free Content Estimating tuberculosis case detection rate in resource-limited countries: a capture-recapture study in Egypt

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Abstract:

SETTING: Most countries endemic and highly endemic for tuberculosis (TB) still do not have reliable TB surveillance systems. Indirect estimation of TB incidence is needed to monitor the performance of the National Tuberculosis Programme (NTP) in the context of the World Health Organization implementation and impact targets for TB control.

OBJECTIVE: To estimate the case detection rate (CDR) of all TB cases and sputum smear-positive TB cases in Egypt in 2007.

METHODS: Record linkage and three-source capture-recapture analysis of data collected through active prospective longitudinal surveillance within the public and private non-NTP sector in four Egyptian governorates selected by stratified cluster random sampling.

RESULTS: For all TB cases, the estimated CDR of NTP surveillance and completeness of case ascertainment after record linkage was respectively 55% (95%CI 46–68) and 62% (95%CI 52–77). For sputum smear-positive TB cases, these proportions were respectively 66% (95%CI 55–75) and 72% (95%CI 60–82).

CONCLUSION: This pilot study shows that representative sampling, prospective surveillance in the non-NTP sector, record linkage and capture-recapture analysis can improve CDR estimation. For global, standardised and reliable use, this methodology should be further developed. Until then, all resource-limited countries should strengthen their national surveillance systems in the context of the Stop TB strategy.

Keywords: capture-recapture analysis; record linkage; resource-limited; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Stop TB Unit, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt 2: Centre for Infections, Health Protection Agency, London, UK 3: National Tuberculosis Control Programme, Cairo, Egypt 4: Stop TB Unit, World Health Organization, Geneva, Switzerland 5: Tuberculosis Control Section, Department of Infectious Disease Control, Rotterdam Public Health Service, Rotterdam, The Netherlands

Publication date: June 1, 2010

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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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