title: Evaluation of active tuberculosis case finding through symptom screening and sputum microscopy of close contacts in Shandong, China.
abstract: OBJECTIVE
  To evaluate the effect of active case finding through symptom screening and sputum microscopy of close contacts in a Fidelis (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project.
  
  
  METHODS
  Secondary data from all 35 counties were collected during implementation and used. They comprised new cases identified, number of close contacts screened and their relationships. Fifty-four in-depth interviews were conducted with staff from key stakeholders.
  
  
  RESULTS
  A total of 13 310 symptomatic contacts of 5255 index cases were screened, and 90 new smear-positive cases were detected with a yield rate of 0.7%. The yield rate of close contacts was positively associated with smear grades of the index cases (P<0.01). Close contacts of cases, such as classmates and workmates, who lived in a closed contained setting, had a higher yield rate than family members (P<0.001). Gaps in project implementation such as training, incentives and sputum collection were identified through in-depth interviews.
  
  
  CONCLUSIONS
  The yield rate of close-contact screening of 0.7% was similar to other findings in China. There was a higher yield from screening of close contacts in congregated settings like schools and workshops. Future active case finding projects should provide clear operational guidelines and adequate training.
authors.affiliation: Shandong Provincial Chest Hospital, Jinan, Shandong Province, China.
authors.forename: Xiulei
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wei
authors.forename: Guanyang
authors.initials: G
authors.lastname: Zou
authors.forename: John
authors.initials: J
authors.lastname: Walley
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhang
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Guo
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016358:Contact Tracing / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015397:Program Evaluation; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology* / Q000635:transmission; D055815:Young Adult