title: Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya.
abstract: BACKGROUND
  Street-connected youth and young adults (SCY) suffer a myriad of health problems. In Kenya, SCY are at high risk for tuberculosis (TB) due to their congregate living situations. TB screening is not routinely implemented in SCY and there has been no published literature on the burden of TB in SCY in western Kenya.
  
  
  METHODS
  In 2011, the AMPATH TB Program, an experienced TB screening program, partnered with the Tumaini Center, a trusted street youth organization, to conduct intensified case finding (ICF) for pulmonary TB among SCY. Our program aimed to investigate the numbers of SCY who reported symptoms and those diagnosed with smear-positive pulmonary TB, and link SCY with TB to treatment.
  
  
  RESULTS
  Of 116 SCY who were screened, 114 (98%) had a positive questionnaire; 104 (90%) provided a spot sputum sample, 39 (34%) provided a morning sputum sample, and 111 (97%) reported cough of >2 weeks. One street youth tested smear-positive for TB and was treated through to cure.
  
  
  CONCLUSIONS
  Implementing TB ICF is feasible in low-resource settings through unique collaborations between health care programs and community-based organizations. In addition to identifying smear-positive TB, our program uncovered a high burden of respiratory symptoms among SCY in Eldoret, Kenya.
authors.affiliation: Tumaini Center, Eldoret, Kenya ; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: D
authors.initials: D
authors.lastname: Szkwarko
authors.affiliation: Tumaini Center, Eldoret, Kenya ; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya ; Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: T
authors.initials: T
authors.lastname: Mercer
authors.affiliation: Tumaini Center, Eldoret, Kenya.
authors.forename: S
authors.initials: S
authors.lastname: Kimani
authors.affiliation: Tumaini Center, Eldoret, Kenya ; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya ; Dalla Lana School of Public Health, Toronto, Ontario, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Braitstein
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya.
authors.forename: N
authors.initials: N
authors.lastname: Buziba
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya ; Moi University School of Medicine, Eldoret, Kenya ; Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Carter
keywords: Kenya; TB; street children; street youth; tuberculosis screening