title: A comparison between passive and active case finding in TB control in the Arkhangelsk region.
abstract: BACKGROUND
  In Russia, active case finding (ACF) for certain population groups has been practiced uninterruptedly for many decades, but no studies comparing ACF and passive case finding (PCF) approaches in Russia have been published.
  
  
  OBJECTIVE
  The aim of this study was to describe the main differences in symptoms and diagnostic delay between patients who come to TB services through PCF and ACF strategies.
  
  
  METHODS
  A cross-sectional study was conducted among 453 new pulmonary tuberculosis (PTB) patients, who met criteria of TB diagnostic delay in Arkhangelsk.
  
  
  RESULTS
  ACF patients used self-treatment more often than PCF patients (90.1% vs. 24.6%) and 36.3% of them were alcohol abusers (as opposed to only 26.2% of PCF patients). The median patient delay (PD) in PCF was 4 weeks, IQR (1-8 weeks), and less than 1 week in ACF. Twenty-three per cent of the PCF patients were seen by a medical provider within the first week of their illness onset.
  
  
  CONCLUSIONS
  Patients diagnosed through ACF tended to under-report their TB symptoms and showed low attention to their own health. However, ACF allowed for discovering TB patients earlier than PCF, and this was also the case for alcohol abusing patients. PCF systems should be supplemented with ACF strategies.
authors.affiliation: Institute of Health and Society, University of Oslo, Oslo, Norway ; Institute of Mental Medicine, Northern State Medical University, Arkhangelsk, Russia ; International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Kuznetsov
authors.affiliation: International School of Public Health, Northern State Medical University, Arkhangelsk, Russia ; Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Andrej M
authors.initials: AM
authors.lastname: Grjibovski
authors.affiliation: Department of Tuberculosis, Northern State Medical University, Arkhangelsk, Russia.
authors.forename: Andrey O
authors.initials: AO
authors.lastname: Mariandyshev
authors.affiliation: Karolinska Institute, Stockholm, Sweden ; Nordic School of Public Health, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Johansson
authors.affiliation: Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Gunnar A
authors.initials: GA
authors.lastname: Bjune
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012424:Rural Population; D012426:Russia / Q000453:epidemiology; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
keywords: active and passive case finding; diagnostic delay; tuberculosis