Screening for active tuberculosis in high-risk groups

Int J Tuberc Lung Dis. 2014 Dec;18(12):1459-65. doi: 10.5588/ijtld.14.0271.

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.

Publication types

  • Evaluation Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Bacteriological Techniques
  • Chi-Square Distribution
  • Drug Resistance, Multiple, Bacterial
  • Drug Users
  • Emigrants and Immigrants
  • Female
  • Homeless Persons
  • Humans
  • Male
  • Mass Screening* / methods
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Odds Ratio
  • Poverty
  • Predictive Value of Tests
  • Prevalence
  • Program Evaluation
  • Radiography, Thoracic
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Spain / epidemiology
  • Sputum / microbiology
  • Tuberculosis, Multidrug-Resistant / diagnosis*
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / microbiology
  • Young Adult

Substances

  • Antitubercular Agents