Active case finding of pulmonary TB in a European refugee camp: Lessons learnt from Oinofyta hosting site in Greece

Background and Objectives: The World Health Organization End tuberculosis (TB) Strategy, approved in 2014, aims at a 90% reduction in TB deaths and an 80% reduction in TB incidence rate by 2030. One of the suggested interventions is the systematic screening of people with suspected TB, belonging to specific risk groups. The Hospital Raoul Follereau (HRF) in Bissau, Guinea-Bissau, is the National Reference Hospital for Tuberculosis and Lung Disease of the country. We performed an active case-finding program among pediatric age family members and cohabitants of admitted adult TB patients, from January to December 2013.Methods: Newly admitted adult patients with a diagnosis of TB were invited to bring their family members or cohabitants in childhood age for clinical evaluation in a dedicated outpatient setting within the hospital compound. All the children brought to our attention underwent medical examination and chest x-ray. In children with clinical and/or radiologic finding consistent with pulmonary TB a sputum-smear was requested.Results: All admitted adult patients accepted to bring their children cohabitants. In total, 287 children were examined in 2013. Forty-four patients (15%) were diagnosed with TB. The number needed to screen (NNS) to detect one case of TB was 7. 35 patients (80%) had pulmonary TB; 2 of them were sputum smear-positive. No adjunctive personnel cost was necessary for the intervention.Conclusions: children with TB represent a large proportion of the pool of undetected TB. A simple TB active case-finding program targeted to high risk groups like children households of severely ill admitted patients with TB can successfully be implemented in a country with limited resources.

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TB contact tracing for young children: an Australian cascade of care review

Public Health Action ◽

10.5588/pha.20.0086 ◽

2021 ◽

Vol 11 (2) ◽

pp. 91-96

Author(s):

N. Moyo ◽

E. L Tay ◽

A. Nolan ◽

H. R. Graham ◽

S. M. Graham ◽

...

Keyword(s):

Young Child ◽

Preventive Treatment ◽

Case Finding ◽

Contact Tracing ◽

High Yield ◽

Sputum Smear ◽

Active Case Finding ◽

Pulmonary Tb ◽

Active Case ◽

Cascade Of Care

OBJECTIVE: To evaluate care cascades for programmatic active case finding and latent TB infection (LTBI) management in young child TB contacts (aged <5 years) in Victoria, Australia.DESIGN: This was a retrospective review of public health surveillance data to identify contacts of all pulmonary TB cases notified from 2016 to 2019.RESULTS: Contact tracing identified 574 young child contacts of 251 pulmonary TB cases. Active TB was found in 28 (4.9%) contacts, none of whom had previously received bacille Calmette-Guérin vaccination, and 529 were tested for TB infection using the tuberculin skin test (TST). The overall TST positivity was 15.3% (95% CI 0.1–0.2). Among the 574 children, 150 (26.1%) were close contacts of sputum smear-positive cases and 25 (16.7%) of these were not referred to TB clinics. Of the 125 referred, 81 were considered to have LTBI, 79 agreed to commence TB preventive treatment (TPT) and 71 (89.9%) completed TPT. Following completion of TPT, no child was subsequently diagnosed with active TB.CONCLUSION: There was a high yield from active case finding and uptake of TPT. Notable losses in the cascade of care occurred around referral to tertiary clinics, but high treatment completion rates and good outcomes were found in those prescribed treatment.

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High Yield of Active Tuberculosis Case Finding Among HIV-Infected Patients Using Xpert MTB/RIF Testing

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz233 ◽

2019 ◽

Vol 6 (6) ◽

Author(s):

Russell R Kempker ◽

Nikoloz Chkhartishvili ◽

Inga Kinkladze ◽

Marcos C Schechter ◽

Kristin Harrington ◽

...

Keyword(s):

Case Finding ◽

High Yield ◽

Molecular Diagnostic ◽

Smear Microscopy ◽

People Living With Hiv ◽

Active Case Finding ◽

Newly Diagnosed ◽

Pulmonary Tb ◽

Active Case ◽

Hcv Antibody

Abstract Objective Conduct an active case finding study in Tbilisi, Georgia, for pulmonary tuberculosis (TB) among people living with HIV (PLWH). Methods Newly diagnosed HIV patients were assessed for symptoms and asked to submit sputum samples for smear microscopy, culture, and molecular diagnostic testing (Xpert MTB/RIF). Results Among 276 PLWH, 131 agreed to participate and 103 submitted sputum samples. Most participants were male (70%) and mean age of 43 years. There were high rates of a positive hepatitis C virus (HCV) antibody test (46%) and the median CD4 count was 122 cells/mm3. A total of 15 (11.5%) persons were diagnosed with pulmonary TB, including 1 each with multidrug-resistant and isoniazid-resistant disease. Twelve had a positive culture for Mycobacterium tuberculosis and Xpert TB/RIF assay, and 4 had positive smear microscopy. Patients with pulmonary TB were more likely to use injection drugs (67% vs 36%, P = .02) and have a positive HCV antibody (73% vs 42%, P = .02). The presence and absence of any TB symptom had a sensitivity and negative predictive value for TB of 93% and 98%, respectively. Conclusion Our findings highlight the high prevalence of TB among newly diagnosed HIV-infected patients in an area with high rates of drug-resistant TB and the utility of an active case finding strategy for TB diagnosis.

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Active case finding and evaluation of IL-6 production among household contacts of pulmonary tuberculosis patients in a high disease setting

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20211863 ◽

2021 ◽

Vol 9 (5) ◽

pp. 1263

Author(s):

Rebecca C. Chukwuanukwu ◽

Charles C. Onyenekwe ◽

Arthur E. Anyabolu ◽

Maria C. Onwunzo ◽

Okonkwo Robert C. ◽

...

Keyword(s):

Disease Burden ◽

Study Groups ◽

Case Finding ◽

Health Concern ◽

Active Case Finding ◽

Blood Samples ◽

Pulmonary Tb ◽

Active Case ◽

Tb Control ◽

Household Contacts

Background: Tuberculosis (TB) is a top infectious disease killer worldwide and remains a huge public health concern. However, most TB case findings are limited to self-referral (passive case finding), when individuals develop symptoms of TB. Only 15% of disease burden in Nigeria are reported. In view of this, it is important to assess the latent and active disease burden amongst HHC of TB patients suffering from pulmonary TB. In addition, it has been suggested that IL-6 levels could be used as a prognostic marker in exposed individuals. IL-6 levels were assessed in this cohort.Methods: A total of 205 subjects participated in this study, comprising 62 pulmonary TB index cases and 143 of their household contacts. Also, 54 apparently healthy subjects were recruited to serve as controls. Active case finding was performed amongst the HHC, using sputum and blood samples; they were tested for active TB. Blood samples were also collected for measuring IL-6 levels.Results: Findings reveal 6.3% previously undiagnosed active TB among the HHC of the TB patients and a significantly higher number of latently infected TB cases compared to the control population (p=0.0078). There were significant differences when comparing HIV co-infected index group to their HIV negative counterparts (P=0.032). Significantly different IL-6 levels were found among the study groups and sub-groups (p<0.0001), with significantly higher levels in TB mono-infection compared to in TB/HIV co-infection (p=0.031).Conclusions: These results demonstrate the importance of active TB case finding for TB control and the possible role of IL-6 as a diagnostic marker in TB control.

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