Pulmonary tuberculosis case detection through fortuitous cough screening during home visits.
OBJECTIVE
To compare the yield of active tuberculosis (TB) case detection among risk groups during home visits with passive detection among patients at health services.


METHODS
In April 2004, in a first phase, we introduced, active screening for coughing among all family members of patients that were visited at home by their family doctor or nurse for other reasons. Subsequently, from October 2004 onwards, active screening was restricted to family members belonging to groups at risk of TB.


RESULTS
The overall detection rate of TB increased from 6.7/100,000 during passive detection at health services before the intervention to 26.2/100,000 inhabitants when passive detection was complemented by active case finding. Active screening among risk groups yielded 35 TB cases per 1000 persons screened compared to 20 TB cases per 1000 persons passively screened at health services. Active case finding was particularly efficient in those coughing for 3 weeks or more (107/1000 screened).


CONCLUSIONS
This study demonstrates that active case finding in groups at risk during home visits increases the case detection rate in the population and permits the identification of cases that may not be detected through passive case finding at health facility level.
González-Ochoa
Edilberto
E
Research and Surveillance Group on TB, Leprosy and ARI, Institute of Tropical Medicine Pedro Kourí, Havana, Cuba. ochoa@ipk.sld.cu
Brooks
Jorge L
JL
Matthys
Francine
F
Calisté
Pausides
P
Armas
Luisa
L
Van der Stuyft
Patrick
P
D016358:Contact Tracing / Q000379:methods; D003371:Cough / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D003462:Cuba / Q000453:epidemiology; D006792:House Calls; D006801:Humans; D033162:Incidental Findings; D008403:Mass Screening / Q000379:methods*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology