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Free Content Active case finding: understanding the burden of tuberculosis in rural South Africa

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SETTING: The Agincourt demographic and health surveillance site in South Africaƕs rural Northern Province.

OBJECTIVES: To accurately assess the true burden of tuberculosis in a rural sub-district with a known high prevalence of human immunodeficiency virus.

DESIGN: Data on hospital registrations of tuberculosis were combined with data from an ongoing demographic health and surveillance system to accurately describe the burden of tuberculosis in a well-defined community. Undiagnosed active cases of sputum-positive disease in the community were detected among chronic coughers identified by heads of household during a single-pass census interview.

RESULTS: The incidence of hospitalised tuberculosis among the permanently resident population (n = 56566) was 212/100000 person-years during 1999. The average point prevalence of detected tuberculosis (all forms) among patients aged over 10 years was 133/100000, and 81/100000 for sputum-positive pulmonary disease. This compares with a point prevalence of 16/100000 cases of sputum-positive disease detected through active case finding.

CONCLUSION: For every nine cases of sputum positive pulmonary tuberculosis being treated at any one time, there are two cases of undiagnosed disease in the community. This study demonstrates a modest burden of undiagnosed tuberculosis among residents in a rural sub-district in South Africa.
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Keywords: South Africa; active case finding; epidemiology; tuberculosis; tuberculosis surveillance

Document Type: Regular Paper

Affiliations: 1: Department of Community Health, University of the Witwatersrand, Medical School, Parktown, Johannesburg, South Africa 2: Directorate HIV/AIDS and STDs, Department of Health, Pretoria, South Africa

Publication date: July 1, 2001

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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 lung health world-wide.

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