title: Screening difficult-to-reach populations for tuberculosis using a mobile medical unit, Punjab India.
abstract: BACKGROUND
  In India, the National Health Mission has provided one mobile medical unit (MMU) per district in the state of Punjab to provide primary health care services for difficult-to-reach populations.
  
  
  OBJECTIVE
  To determine the number of patients with presumptive tuberculosis (TB) and the number of TB cases detected and treated among patients who used the MMU services from May to December 2012 in Mohali district, Punjab, India.
  
  
  METHODS
  A cross-sectional study was conducted and registers of the out-patient, laboratory, radiology, and TB departments of the MMU were reviewed to determine the number of persons presumed to have TB and the number of persons diagnosed with TB.
  
  
  RESULTS
  Of 8346 patients who attended the MMUs, 663 (8%) had symptoms suggestive of TB. Among those with TB symptoms, 540 (81%) were evaluated for pulmonary TB using sputum examination or chest X-ray. In total, 58 (11%) patients had clinical or laboratory evidence of pulmonary TB, of whom 21 (36%) started anti-tuberculosis treatment.
  
  
  CONCLUSIONS
  As MMUs are an integral part of the general public health system, these units have the potential to detect TB cases among difficult-to-reach populations. Additional research is required to optimise the diagnosis of TB at MMUs and to increase rates of TB treatment initiation.
authors.affiliation: District Tuberculosis Centre, Mohali District, Punjab, India.
authors.forename: G
authors.initials: G
authors.lastname: Binepal
authors.affiliation: Department of Tuberculosis, World Health Organization Country Office for India, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Civil Hospital Mohali District, Punjab, India.
authors.forename: N
authors.initials: N
authors.lastname: Kaur
authors.affiliation: Directorate of Health Services, Punjab, India.
authors.forename: B
authors.initials: B
authors.lastname: Singh
authors.affiliation: Civil Hospital Mohali District, Punjab, India.
authors.forename: V
authors.initials: V
authors.lastname: Bhagat
authors.affiliation: Civil Hospital Mohali District, Punjab, India.
authors.forename: R P
authors.initials: RP
authors.lastname: Verma
authors.affiliation: International Union Against Tuberculosis and Lung Disease South-East Asia Regional Office, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
authors.affiliation: Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Oeltmann
authors.affiliation: Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Moonan
keywords: India; chest X-ray; mobile; remote populations; tuberculosis