Tuberculosis active case finding: uptake and diagnostic yield among minibus drivers in urban South Africa
Published Date:Mar 14 2015
Source:BMC Public Health. 15.
Pubmed Central ID:PMC4364653
Funding:U2R TW007370/TW/FIC NIH HHS/United States
U62 PS024055/PS/NCHHSTP CDC HHS/United States
K23 AI083099/AI/NIAID NIH HHS/United States
AI083099/AI/NIAID NIH HHS/United States
PS024055/PS/NCHHSTP CDC HHS/United States
U2G PS000811/PS/NCHHSTP CDC HHS/United States
Tuberculosis (TB) active case finding is a part of TB control in areas of higher TB prevalence. Congested public transportation settings may be areas of increased TB transmission. We evaluated the uptake and diagnostic yield of an active TB screening program among minibus drivers in a large public transportation facility in Johannesburg, South Africa.
Over an eight month period, we intensively recruited minibus drivers for TB screening with a goal of 80% uptake among the estimated 2000 drivers. All participants were screened for TB symptoms, offered HIV testing, and had sputum collected for smear microscopy and liquid culture.
686 drivers were screened for TB, representing an uptake of only 34% of all drivers (43% of the target screening). Ten drivers (1.5%) were culture positive for TB, nine of whom were sputum smear microscopy negative. Factors associated with previously undiagnosed TB included a history of incarceration (odds ratio [OR] 5.5, 95% confidence interval: 1.1, 27.3) and HIV positivity (OR 5.3, 95% confidence interval: 1.1, 26.3).
We identified undiagnosed pulmonary TB cases among drivers but at a level that may be insufficient to justify systematic case finding in this population considering the poor uptake.
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