Passive case finding for tuberculosis is not enough

Jennifer Ho; Greg J Fox; Ben J Marais

doi:10.1016/j.ijmyco.2016.09.023

Passive case finding for tuberculosis is not enough

Int J Mycobacteriol. 2016 Dec;5(4):374-378. doi: 10.1016/j.ijmyco.2016.09.023. Epub 2016 Oct 28.

Authors

Jennifer Ho¹, Greg J Fox², Ben J Marais³

Affiliations

¹ Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, Australia; Centre for Research Excellence in Tuberculosis (TB-CRE) and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia. Electronic address: jennifer.ho@sydney.edu.au.
² Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Centre for Research Excellence in Tuberculosis (TB-CRE) and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia.
³ Centre for Research Excellence in Tuberculosis (TB-CRE) and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia; The Children's Hospital at Westmead, University of Sydney, Sydney, Australia.

PMID: 27931676
DOI: 10.1016/j.ijmyco.2016.09.023

Abstract

Current World Health Organisation targets calling for an end to the global tuberculosis (TB) epidemic by 2035 require a dramatic improvement in current case-detection strategies. A reliance on passive case finding (PCF) has resulted consistently, in over three million infectious TB cases per year, being missed by the health system, leading to ongoing transmission of infection within families and communities. Active case finding (ACF) for TB has been recognized as an important complementary strategy to PCF, in order to diagnose and treat patients earlier, reducing the period of infectiousness and therefore transmission. ACF may also achieve substantial population-level TB control. Local TB epidemiology and the resources available in each setting will influence which populations should be screened, and the types of ACF interventions to use for maximal impact. TB control programs should begin with the highest risk groups and broaden their activities as resources allow. Mathematical models can help to predict the population-level effects and the cost-effectiveness of a variety of ACF strategies on different risk populations.

Keywords: Active case finding; Diagnosis; End TB strategy; Screening; TB elimination.

Publication types

Review

MeSH terms

Disease Eradication / methods*
Disease Transmission, Infectious / prevention & control*
Humans
Mass Screening / methods*
Tuberculosis / diagnosis*
Tuberculosis / epidemiology*
Tuberculosis / transmission