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