title: Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania.
abstract: METHODS
  Active case finding is a World Health Organization (WHO) endorsed strategy for improving tuberculosis (TB) case detection. Despite WHO recommendations for active case finding among people who inject drugs (PWID), few studies have been published. The historical focus of case finding has been in populations that are human immunodeficiency virus-positive, incarcerated or at higher occupational risk.
  
  
  OBJECTIVE
  We sought to examine the yield of active case finding among PWID newly started on methadone in Tanzania.
  
  
  METHODS
  Of 222 methadone clients, 156 (70%) met with study administrators; 150 consented to participate, 139 (93%) of whom were male. The median age was 34 years. A symptom-based questionnaire was developed by the investigators and administered to every consenting patient by a native Swahili speaker.
  
  
  RESULTS
  Of the 150 patients surveyed, 16 (11%) had one or more TB symptoms and were referred for laboratory testing. Six new TB cases were identified in this active case finding program, with a prevalence of 4%.
  
  
  CONCLUSIONS
  This study presents the first data on TB prevalence in a population of PWID in Tanzania. This prevalence is 23 times that of the general Tanzanian TB prevalence of 0.2%. These results have significant implications for TB control.
authors.affiliation: <label>*</label>Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.affiliation: <label><sup>†</sup></label>Muhimbili University of Health and Allied Sciences, Dar es Salaam.
authors.forename: J
authors.initials: J
authors.lastname: Mbwambo
authors.affiliation: <label><sup>‡</sup></label>Muhimbili National Hospital, Dar es Salaam.
authors.forename: I
authors.initials: I
authors.lastname: Mteza
authors.affiliation: <label>*</label>Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shenoi
authors.affiliation: <label><sup>§</sup></label>Pangaea Global AIDS Foundation, Oakland, California, USA.
authors.forename: B
authors.initials: B
authors.lastname: Lambdin
authors.affiliation: <label><sup>†</sup></label>Muhimbili University of Health and Allied Sciences, Dar es Salaam.
authors.forename: C
authors.initials: C
authors.lastname: Nyandindi
authors.affiliation: <label><sup>¶</sup></label>Central TB Reference Laboratory, Dar es Salaam, Tanzania.
authors.forename: B I
authors.initials: BI
authors.lastname: Doula
authors.affiliation: <label><sup>¶</sup></label>Central TB Reference Laboratory, Dar es Salaam, Tanzania.
authors.forename: S
authors.initials: S
authors.lastname: Mfaume
authors.affiliation: <label>*</label>Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Bruce
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology; D014944:World Health Organization
chemical_list: D008691:Methadone