title: Tuberculosis active case finding: uptake and diagnostic yield among minibus drivers in urban South Africa.
abstract: BACKGROUND
  Tuberculosis (TB) active case finding is a part of TB control in areas of higher TB prevalence. Congested public transportation settings may be areas of increased TB transmission. We evaluated the uptake and diagnostic yield of an active TB screening program among minibus drivers in a large public transportation facility in Johannesburg, South Africa.
  
  
  METHODS
  Over an eight month period, we intensively recruited minibus drivers for TB screening with a goal of 80% uptake among the estimated 2000 drivers. All participants were screened for TB symptoms, offered HIV testing, and had sputum collected for smear microscopy and liquid culture.
  
  
  RESULTS
  686 drivers were screened for TB, representing an uptake of only 34% of all drivers (43% of the target screening). Ten drivers (1.5%) were culture positive for TB, nine of whom were sputum smear microscopy negative. Factors associated with previously undiagnosed TB included a history of incarceration (odds ratio [OR] 5.5, 95% confidence interval: 1.1, 27.3) and HIV positivity (OR 5.3, 95% confidence interval: 1.1, 26.3).
  
  
  CONCLUSIONS
  We identified undiagnosed pulmonary TB cases among drivers but at a level that may be insufficient to justify systematic case finding in this population considering the poor uptake.
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. tmabuto@auruminstitute.org.|School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. tmabuto@auruminstitute.org.
authors.forename: Tonderai
authors.initials: T
authors.lastname: Mabuto
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. ezwane@auruminstitute.org.
authors.forename: Ephraim
authors.initials: E
authors.lastname: Zwane
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. vchihota@auruminstitute.org.|School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. vchihota@auruminstitute.org.
authors.forename: Violet
authors.initials: V
authors.lastname: Chihota
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. ggresak@auruminstitute.org.
authors.forename: Gillian
authors.initials: G
authors.lastname: Gresak
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. scharalambous@auruminstitute.org.|School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. scharalambous@auruminstitute.org.
authors.forename: Salome
authors.initials: S
authors.lastname: Charalambous
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. gchurchyard@auruminstitute.org.|School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. gchurchyard@auruminstitute.org.|London School of Hygiene and Tropical Medicine, London, UK. gchurchyard@auruminstitute.org.
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Churchyard
authors.affiliation: The Aurum Institute, Johannesburg, South Africa. choffmann@jhmi.edu.|School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. choffmann@jhmi.edu.|Division of Infectious Diseases, Johns Hopkins University School of Medicine, 725 N Wolfe St, Rm 226, Baltimore, Maryland, 21205, USA. choffmann@jhmi.edu.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D001334:Automobile Driving; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008853:Microscopy; D008875:Middle Aged; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D013183:Sputum; D014186:Transportation; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology; D014505:Urban Population