title: Implementation and Operational Research: Population-Based Active Tuberculosis Case Finding During Large-Scale Mobile HIV Testing Campaigns in Rural Uganda.
abstract: Active tuberculosis (TB) screening outside clinics and in communities may reduce undiagnosed TB.
  
  
  
  To determine the yield of TB screening during community-based HIV testing campaigns (CHC) in 7 rural Ugandan communities within an ongoing cluster-randomized trial of universal HIV testing and treatment (SEARCH, NCT:01864603), we offered sputum microscopy to participants with prolonged cough (>2 weeks). We determined the number of persons needed to screen to identify one TB case, and the number of cases identified that linked to clinic and completed TB treatment.
  
  
  
  Of 36,785 adults enumerated in 7 communities, 27,214 (74%) attended CHCs, and HIV testing uptake was >99%, with 941 (3.5%) HIV-infected adults identified. Five thousand seven hundred eighty-six adults (21%) reported cough and 2876 (11%) reported cough >2 weeks. Staff obtained sputum in 1099/2876 (38%) participants with prolonged cough and identified 10 adults with AFB-positive sputum; 9 new diagnoses and 1 known case already under treatment. The number needed to screen to identify one new TB case was 3024 adults overall: 320 adults with prolonged cough and 80 HIV-infected adults with prolonged cough. All 9 newly diagnosed AFB+ participants were linked to TB care within 2 weeks and were initiated TB treatment.
  
  
  
  In a rural Ugandan setting, TB screening as an adjunct to large-scale mobile HIV testing campaigns provides an opportunity to increase TB case detection.
authors.affiliation: *Makerere University-University of California, San Francisco Research Collaboration, Kampala, Uganda; †Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, CA; ‡Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA; §University of California Berkeley School of Public Health, Berkeley, CA; and ‖Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ssemmondo
authors.forename: Florence
authors.initials: F
authors.lastname: Mwangwa
authors.forename: Joel L
authors.initials: JL
authors.lastname: Kironde
authors.forename: Dalsone
authors.initials: D
authors.lastname: Kwarisiima
authors.forename: Tamara D
authors.initials: TD
authors.lastname: Clark
authors.forename: Carina
authors.initials: C
authors.lastname: Marquez
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Charlebois
authors.forename: Maya L
authors.initials: ML
authors.lastname: Petersen
authors.forename: Moses R
authors.initials: MR
authors.lastname: Kamya
authors.forename: Diane V
authors.initials: DV
authors.lastname: Havlir
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chamie
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008952:Mobile Health Units; D009874:Operations Research; D016032:Randomized Controlled Trials as Topic; D019035:Rural Health Services; D012424:Rural Population; D014376:Tuberculosis / Q000175:diagnosis*; D014454:Uganda