title: Active case finding of tuberculosis (TB) in an emergency room in a region with high prevalence of TB in Brazil.
abstract: METHODS
  Public hospital emergency room (ER) in Porto Alegre, Brazil, a setting with high prevalence of tuberculosis (TB) and human immunodeficiency virus (HIV) infection.
  
  
  OBJECTIVE
  To determine the prevalence of PTB, using a symptom based active case finding (ACF) strategy in the ER of a public hospital in an area with high prevalence of TB and HIV, as well as variables associated with pulmonary TB diagnosis.
  
  
  METHODS
  Cross sectional study. All patients ≥ 18 years seeking care at the ER were screened for respiratory symptoms and those with cough ≥ 2 weeks were invited to provide a chest radiograph and two unsupervised samples of sputum for acid-fast bacilli smear and culture.
  
  
  RESULTS
  Among 31,267 admissions, 6,273 (20.1%) reported respiratory symptoms; 197 reported cough ≥ 2 weeks, of which pulmonary TB was diagnosed in 30. In multivariate analysis, the variables associated with a pulmonary tuberculosis diagnosis were: age (OR 0.94, 95% CI: 0.92-0.97; p<0.0001), sputum production (OR 0.18, 95% CI 0.06-0.56; p = 0.003), and radiographic findings typical of TB (OR 12.11, 95% CI 4.45-32.93; p<0.0001).
  
  
  CONCLUSIONS
  This study identified a high prevalence of pulmonary TB among patients who sought care at the emergency department of a tertiary hospital, emphasizing the importance of regular screening of all comers for active TB in this setting.
authors.affiliation: Pulmonology Department, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul - Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Denise Rossato
authors.initials: DR
authors.lastname: Silva
authors.affiliation: Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Alice Mânica
authors.initials: AM
authors.lastname: Müller
authors.affiliation: Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Karina da Silva
authors.initials: Kda S
authors.lastname: Tomasini
authors.affiliation: Pulmonology Department, Faculdade de Medicina da Universidade Federal do Rio Grande do Sul - Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Paulo de Tarso Roth
authors.initials: Pde T
authors.lastname: Dalcin
authors.affiliation: Epidemiology Department, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Golub
authors.affiliation: Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Marcus Barreto
authors.initials: MB
authors.lastname: Conde
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D062606:Tertiary Care Centers; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*