Community-based active case finding for tuberculosis in rural western China: a cross-sectional study
OBJECTIVE: To evaluate a community-based, active case finding (ACF) scheme in identifying symptomatic individuals with TB.
DESIGN: We conducted door-to-door household visits of all residents aged 15 years at two rural sites to screen for TB symptoms. Individuals with symptoms were enrolled and asked to provide three sputum samples. All participants underwent chest X-ray, and microbiologic detection of Mycobacterium tuberculosis from sputum samples using microscopy, solid culture and Xpert® MTB/RIF was performed.
RESULTS: Among the 19 334 residents screened for TB symptoms, 865 (4.5%) reported having 1 symptom. A total of 52 TB cases were detected, 11 of whom had microbiologic confirmation. Xpert identified all five M. tuberculosis culture-positive cases and yielded an additional three diagnoses. Prevalence of newly detected TB at the two sites through ACF was respectively 475 and 196 per 100 000 population. These estimates are respectively four and eight times, on average, higher than those identified through passive surveillance during the previous 5-year period for the two sites.
CONCLUSION: Community-based symptom screening followed by laboratory tests was found to be feasible and effective in increasing TB case finding in rural China.
Keywords: Xpert; epidemiology; population-based study; rural settings
Document Type: Research Article
Affiliations: 1: Aeras, Beijing, China, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany 2: Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Science, Fudan University, Shanghai, China, Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, USA 3: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany, Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Science, Fudan University, Shanghai, China 4: Guangxi Pingguo Center for Disease Control and Prevention, Pingguo, Guangxi 5: Sichuan Wusheng Center for Disease Control and Prevention, Wusheng, Sichuan 6: Chinese Center for Disease Control and Prevention, Beijing, China 7: Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Science, Fudan University, Shanghai, China 8: Aeras, Rockville, Maryland, USA, The Aurum Institute, Johannesburg, South Africa
Publication date: 01 November 2017
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