title: Screening for active tuberculosis in high-risk groups.
abstract: OBJECTIVE
  To evaluate an active case-finding strategy among drug users (DUs), economically disadvantaged individuals and recent immigrants from hyperendemic countries, a population at high risk of developing tuberculosis (TB).
  
  
  METHODS
  Retrospective, observational study carried out by the Tuberculosis Unit of the City of Barcelona from September 2009 to December 2012. All participants underwent chest X-ray and were screened for symptoms.
  
  
  RESULTS
  Of 5982 participants screened, 30 TB cases were detected (total prevalence 0.5%): 26 were pulmonary, 8 were smear-positive and 2 were resistant to multiple drugs. Directly observed treatment was advised for 19 patients (63%). TB prevalence in the recent immigrants group was significantly greater (1.77%) than in all other groups studied: economically disadvantaged individuals 0.30% (RR 5.9, 95%CI 2.30-15.14); DUs 0.62% (RR 2.05, 95%CI 0.91-4.64), non-recent immigrants 0.41% (RR 4.31, 95%CI 1.68-11.4); and all native-born individuals 0.41% (RR 4.33, 95%CI 1.71-10.92). The rate was much greater than the estimated prevalence for the general population of the city (∼20 cases/100,000 population).
  
  
  CONCLUSIONS
  In high-risk groups, active case finding can be used as a public health intervention to detect a large number of TB cases.
authors.affiliation: Special Program on Infectious Diseases, Tuberculosis Unit, Vall d'Hebrón-Drassanes, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: Jiménez-Fuentes
authors.affiliation: Special Program on Infectious Diseases, Tuberculosis Unit, Vall d'Hebrón-Drassanes, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
authors.forename: C Milà
authors.initials: CM
authors.lastname: Augé
authors.affiliation: Special Program on Infectious Diseases, Tuberculosis Unit, Vall d'Hebrón-Drassanes, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
authors.forename: M N Altet
authors.initials: MN
authors.lastname: Gómez
authors.affiliation: Special Program on Infectious Diseases, Tuberculosis Unit, Vall d'Hebrón-Drassanes, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
authors.forename: J Solsona
authors.initials: JS
authors.lastname: Peiró
authors.affiliation: Special Program on Infectious Diseases, Tuberculosis Unit, Vall d'Hebrón-Drassanes, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
authors.forename: M L
authors.initials: ML
authors.lastname: de Souza Galvao
authors.affiliation: Directly Observed Treatment Unit, Serveis Clínics, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Maldonado
authors.affiliation: Directly Observed Treatment Unit, Serveis Clínics, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Molina-Pinargote
authors.affiliation: Epidemiology Service, Agencia de Salud Pública de Barcelona, Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Orcau
authors.affiliation: Epidemiology Service, Agencia de Salud Pública de Barcelona, Consorcio de Investigación Biomédica de Epidemiología y Salud Pública, Madrid, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Cayla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D016009:Chi-Square Distribution; D024901:Drug Resistance, Multiple, Bacterial; D055030:Drug Users; D054242:Emigrants and Immigrants; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016017:Odds Ratio; D011203:Poverty; D011237:Predictive Value of Tests; D015995:Prevalence; D015397:Program Evaluation; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents