Success of active tuberculosis case detection among high-risk groups in urban slums in Pakistan

Int J Tuberc Lung Dis. 2014 Sep;18(9):1099-104. doi: 10.5588/ijtld.14.0001.

Abstract

Background: In Pakistan, patients with symptoms suggestive of tuberculosis (TB) seek care from a wide array of health care providers, many of whom do not notify cases to the National TB Programme (NTP).

Setting: We evaluated an active case detection intervention in five randomly selected districts in urban slums of Sindh Province, Pakistan.

Objective: To evaluate the increase in case notification of smear-positive TB by active case finding at community-based chest camps by engaging the private providers.

Design: A cross-sectional study of TB case detection associated with a project using integrated intervention and chest camps.

Results: From April 2011 to September 2012, the total number of clients seen in the camps was 165 280. Of all the attendees, 13 481 (12.7%) were examined by sputum smear microscopy. The proportion of smear-positive results was significantly higher among those from engaged private providers than among those referred from camps (OR 1.54, 95%CI 1.42-1.66). During the project, the total number of smear-positive TB notifications increased over the intervention period from 5158 to 8275.

Conclusion: Active case detection by engaging private providers and chest camps can significantly increase the number of smear-positive TB case notifications.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bacteriological Techniques*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • General Practice
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Microscopy, Fluorescence*
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Odds Ratio
  • Pakistan / epidemiology
  • Poverty Areas*
  • Predictive Value of Tests
  • Private Sector
  • Program Evaluation
  • Risk Factors
  • Sputum / microbiology
  • Time Factors
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / microbiology
  • Urban Health*
  • Young Adult