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Free Content Capture-recapture to estimate completeness of tuberculosis surveillance in two communities in South Africa

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BACKGROUND: Reliable surveillance is essential for any tuberculosis (TB) control programme; however, under-registration of TB cases due to under-notification of patients on treatment or failure to initiate treatment has been well-documented internationally.

OBJECTIVE: To determine the contribution of capture-recapture methods in estimating the completeness of bacteriologically confirmed pulmonary TB registration in two high-incident communities in South Africa.

METHODS: Record linkage between the TB treatment register and two laboratory sputum TB result registers and three-source log-linear capture-recapture analysis.

RESULTS: The number of bacteriologically confirmed pulmonary TB cases in the TB treatment register was 243, with an additional 63 cases identified in the two laboratory databases, resulting in 306 TB cases. The observed completeness of the TB treatment register was 79%. The log-linear model estimated 326 (95%CI 314–355) TB cases, resulting in an estimated completeness of registration of 75% (95%CI 68–77).

CONCLUSION: Capture-recapture can be useful in evaluating the completeness of TB control surveillance and registration, including in resource-limited settings; however, methodology and results should be carefully assessed. Interventions are needed to increase the completeness of registration and to reduce the number of initial defaulters.

Keywords: capture-recapture; case registration; initial defaulters; record linking; tuberculosis

Document Type: Regular Paper


Affiliations: 1: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa 2: Department of Tuberculosis Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands 3: KNCV Tuberculosis Foundation, The Hague, The Netherlands; and Centre for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, The Netherlands 4: International Union Against Tuberculosis and Lung Disease, Paris, France 5: Biostatistics Unit, Medical Research Council, Cape Town, South Africa 6: Division of Community Health, Stellenbosch University, Cape Town, South Africa

Publication date: August 1, 2011

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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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