title: Active detection of tuberculosis and paragonimiasis in the remote areas in North-Eastern India using cough as a simple indicator.
abstract: One of the essential steps in targeting tuberculosis (TB) intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. In the North-Eastern (NE) region of India pulmonary TB and paragonimiasis are overlapping public health issues. We performed a cross-sectional study in 63 remote villages from the two states Arunachal Pradesh (AP) and Assam to determine the prevalence of undiagnosed TB and paragonimiasis cases using cough as a simple indicator. In AP, 2961 individuals aged five years and above were examined and 1108 (37·4%) were found to have cough for one week or more. Of the 417 individuals who provided sputum, 11 (2·64%) were smear positive for acid-fast bacilli (AFB). All these cases were yet undiagnosed, thus the prevalence of new smear positive TB in AP was 0·37%. In Assam on the other hand 331 (23·5%) subjects out of 1410 individuals who were examined had a cough for one week or more and of the 112 individuals who provided sputum, 13 (11·6%) were smear positive for AFB. The prevalence of new smear positive TB cases was 0·78% in Assam. Sero-positivity of paragonimiasis in coughers of AP was 7·6% (n = 1091), which was significantly higher (p < 0·01) as compared to that in Assam (1·2%, n = 321). The findings of the present study suggest that TB remains a major public health concern in the NE region of India especially in the remote places and there is need to strengthen early case detection of TB.
authors.affiliation: Department of Environmental Health Sciences, Kochi Medical School, Kochi, Japan.
authors.forename: Kangjam
authors.initials: K
authors.lastname: Rekha Devi
authors.forename: Kanwar
authors.initials: K
authors.lastname: Narain
authors.forename: Jagadish
authors.initials: J
authors.lastname: Mahanta
authors.forename: Rumi
authors.initials: R
authors.lastname: Deori
authors.forename: Kabang
authors.initials: K
authors.lastname: Lego
authors.forename: Dibyajyoti
authors.initials: D
authors.lastname: Goswami
authors.forename: Sanjib
authors.initials: S
authors.lastname: Kumar Rajguru
authors.forename: Takeshi
authors.initials: T
authors.lastname: Agatsuma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000909:Antibodies, Helminth / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D010237:Paragonimiasis / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth