title: Success of active tuberculosis case detection among high-risk groups in urban slums in Pakistan.
abstract: BACKGROUND
  In Pakistan, patients with symptoms suggestive of tuberculosis (TB) seek care from a wide array of health care providers, many of whom do not notify cases to the National TB Programme (NTP).
  
  
  METHODS
  We evaluated an active case detection intervention in five randomly selected districts in urban slums of Sindh Province, Pakistan.
  
  
  OBJECTIVE
  To evaluate the increase in case notification of smear-positive TB by active case finding at community-based chest camps by engaging the private providers.
  
  
  METHODS
  A cross-sectional study of TB case detection associated with a project using integrated intervention and chest camps.
  
  
  RESULTS
  From April 2011 to September 2012, the total number of clients seen in the camps was 165 280. Of all the attendees, 13 481 (12.7%) were examined by sputum smear microscopy. The proportion of smear-positive results was significantly higher among those from engaged private providers than among those referred from camps (OR 1.54, 95%CI 1.42-1.66). During the project, the total number of smear-positive TB notifications increased over the intervention period from 5158 to 8275.
  
  
  CONCLUSIONS
  Active case detection by engaging private providers and chest camps can significantly increase the number of smear-positive TB case notifications.
authors.affiliation: National Tuberculosis Control Program Pakistan, Islamabad, Pakistan.
authors.forename: R
authors.initials: R
authors.lastname: Fatima
authors.affiliation: National Tuberculosis Control Program Pakistan, Islamabad, Pakistan.
authors.forename: E
authors.initials: E
authors.lastname: Qadeer
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: D A
authors.initials: DA
authors.lastname: Enarson
authors.affiliation: TB REACH Stop TB Partnership, World Health Organization, Geneva, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Creswell
authors.forename: R H
authors.initials: RH
authors.lastname: Stevens
authors.affiliation: HLSP Institute, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Stevens
authors.affiliation: University of Bergen, Bergen, Norway.
authors.forename: S G
authors.initials: SG
authors.lastname: Hinderaker
authors.forename: K
authors.initials: K
authors.lastname: Anwar
authors.affiliation: National Tuberculosis Control Program Pakistan, Islamabad, Pakistan.
authors.forename: M
authors.initials: M
authors.lastname: ul Haq
mesh_terms: D000293:Adolescent; D000328:Adult; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016017:Odds Ratio; D010154:Pakistan / Q000453:epidemiology; D011204:Poverty Areas; D011237:Predictive Value of Tests; D017149:Private Sector; D015397:Program Evaluation; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D014504:Urban Health; D055815:Young Adult