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Evaluación del hallazgo de casos activos de tuberculosis mediante la búsqueda de síntomas y microscopía de esputo de contactos cercanos en Shandong, China
Author(s) -
Zhang Xiulei,
Wei Xiaolin,
Zou Guanyang,
Walley John,
Zhang Hongmei,
Guo Xiaoyan,
Zhu Li,
Liu Zhimin
Publication year - 2011
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2011.02869.x
Subject(s) - sputum , tuberculosis , case finding , medicine , incentive , yield (engineering) , china , active tuberculosis , geography , pathology , mycobacterium tuberculosis , materials science , archaeology , economics , metallurgy , microeconomics
Summary Objectives To evaluate the effect of active case finding through symptom screening and sputum microscopy of close contacts in a Fidelis (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project. Methods Secondary data from all 35 counties were collected during implementation and used. They comprised new cases identified, number of close contacts screened and their relationships. Fifty‐four in‐depth interviews were conducted with staff from key stakeholders. Results A total of 13 310 symptomatic contacts of 5255 index cases were screened, and 90 new smear‐positive cases were detected with a yield rate of 0.7%. The yield rate of close contacts was positively associated with smear grades of the index cases ( P < 0.01). Close contacts of cases, such as classmates and workmates, who lived in a closed contained setting, had a higher yield rate than family members ( P < 0.001). Gaps in project implementation such as training, incentives and sputum collection were identified through in‐depth interviews. Conclusions The yield rate of close‐contact screening of 0.7% was similar to other findings in China. There was a higher yield from screening of close contacts in congregated settings like schools and workshops. Future active case finding projects should provide clear operational guidelines and adequate training.