Epidemiological impact of mass tuberculosis screening: a 2-year follow-up after a national prevalence survey
Abstract:OBJECTIVE: To assess the epidemiological impact of mass tuberculosis (TB) screening in the community and the prognosis of bacteriologically negative individuals with abnormal findings on chest radiography (CXR).
METHODS: A follow-up study consisting of two parts—a register match of notified TB cases with 22 160 participants in a national TB prevalence survey, and a repeat medical examination for the subjects of a prevalence survey with abnormal findings on CXR—was conducted 2 years after the prevalence survey in Cambodia.
RESULTS: Thirty-four cases with new smear-positive TB were detected by register match, giving a standardised notification ratio of 0.38 (95%CI 0.27–0.52). An additional seven new smear-positive TB cases and 93 new smear-negative, culture-positive TB cases were detected by medical examination. The incidence rates of bacteriologically positive TB were 8.5% per year (95%CI 6.3–11.2) in cases with a CXR suggestive of active TB and 2.9% per year (95%CI 2.2–3.7) in those with a CXR with other abnormalities.
CONCLUSIONS: Detection and treatment of smear-negative, culture-positive TB cases as well as smear-positive TB cases was associated with a rapid reduction in subsequent incidence of new smear-positive TB. Sputum culture-negative individuals with abnormal CXR findings are at a high risk of disease progression, and require follow-up and potentially preventive treatment.
Document Type: Research Article
Affiliations: 1: Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; Japan International Cooperation Agency/National TB Control Project, Phnom Penh, Cambodia 2: Stop TB Department, World Health Organization, Geneva, Switzerland 3: Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan 4: Japan International Cooperation Agency/National TB Control Project, Phnom Penh, Cambodia 5: National Center for Tuberculosis and Leprosy Control, Phnom Penh, Cambodia
Publication date: December 1, 2012
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