Kui Liu1, Ying Peng1, Qinrong Zhou2, Jun Cheng3, Hao Yu4, Lihong Tang5, Bin Chen1, Wei Wang1, Fei Wang1, Tieniu He1, Yu Zhang1, Lin Zhou1, Songhua Chen1, Chengliang Chai1, Hongdan Bao1, Xiaomeng Wang6, Jianmin Jiang7. 1. Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. 2. Jiangshan Municipal Center for Disease Control and Prevention, Quzhou, Zhejiang Province, People's Republic of China. 3. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China. 4. Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, People's Republic of China. 5. Minhang District Center for Disease Control and Prevention, Shanghai, People's Republic of China. 6. Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. Electronic address: xmwang@cdc.zj.cn. 7. Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China; Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. Electronic address: Jmjiang@cdc.zj.cn.
Abstract
BACKGROUND: Tuberculosis (TB) is a critical global public threat, and limited epidemiology studies have been performed to explore the efficacy of active TB screening. METHODS: Three sites located in eastern China were chosen in 2013, and three rounds of systematic screenings were performed in permanent residents aged older than 15 years. RESULTS: The TB incidence showed a downtrend after several rounds of active screening at the three sites, and a significant change was observed at site A in the overall population. In the target population at sites A and B, both the elderly and people with a history of TB had a remarkable decline through the first or second round of screening. The implementation of active case-finding identified 2.36 [1.47,3.81] (2013 vs. 2012) and 1.49 [1.1,2.03] (2013-2015 vs. 2010-2012) more potential cases than the passive case-finding by the surveillance system at site A. CONCLUSIONS: Active case-finding of tuberculosis might be effective in high prevalence area with a low economic level, particularly among the elderly and people with a history of TB. Additionally, new rapid diagnosis technology should be considered to decrease the prevalence among people with a history of TB. Ultimately, active screening identified more active TB cases than passive case-finding, particularly in high prevalence area with underdeveloped economics.
BACKGROUND:Tuberculosis (TB) is a critical global public threat, and limited epidemiology studies have been performed to explore the efficacy of active TB screening. METHODS: Three sites located in eastern China were chosen in 2013, and three rounds of systematic screenings were performed in permanent residents aged older than 15 years. RESULTS: The TB incidence showed a downtrend after several rounds of active screening at the three sites, and a significant change was observed at site A in the overall population. In the target population at sites A and B, both the elderly and people with a history of TB had a remarkable decline through the first or second round of screening. The implementation of active case-finding identified 2.36 [1.47,3.81] (2013 vs. 2012) and 1.49 [1.1,2.03] (2013-2015 vs. 2010-2012) more potential cases than the passive case-finding by the surveillance system at site A. CONCLUSIONS: Active case-finding of tuberculosis might be effective in high prevalence area with a low economic level, particularly among the elderly and people with a history of TB. Additionally, new rapid diagnosis technology should be considered to decrease the prevalence among people with a history of TB. Ultimately, active screening identified more active TB cases than passive case-finding, particularly in high prevalence area with underdeveloped economics.
Authors: Rachael M Burke; Marriott Nliwasa; Helena R A Feasey; Lelia H Chaisson; Jonathan E Golub; Fahd Naufal; Adrienne E Shapiro; Maria Ruperez; Lily Telisinghe; Helen Ayles; Elizabeth L Corbett; Peter MacPherson Journal: Lancet Public Health Date: 2021-03-22