DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20193447

Active detection of tuberculosis: tackling the problem head on in the remote area of Andaman and Nicobar Islands

Samarendra Prasanna Burma, Gunda Jahnavi, Pappachen Lal, Pandurang V. Thatkar

Abstract


Background: Community based active case finding for tuberculosis (TB) is an essential step in the fight forward for eliminating TB. One of the steps in targeting TB intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. Active case finding (ACF) targeting the entire population by house to house survey was done in Nicobar district of these islands.

Methods: A community-based, cross-sectional, descriptive study was conducted with the trained mobile teams from 17.07.2017 to 31.07.2017 in the Nicobar District. The algorithm of the case detection included screening patients by symptoms, then by sputum microscopy for confirmation. X-ray was done in patients who were symptomatic but sputum negative. If both smear and chest X-ray results were negative but still symptomatic, then cartridge-based nucleic acid amplification test (CBNAAT) was done.

Results: A total population of 18526 was mapped of which 14784 (79.8) could be screened. A total of 209 people were identified by the mobile teams with symptoms who were examined by sputum microscopy. Among them 7 cases were identified to be sputum smear positive, 2 X-ray positive and 2 were diagnosed by CBNAAT.

Conclusions: This study shows that the active case finding method is feasible and acceptable by the community. The results obtained are encouraging for the implementation of ACF through mobile team activity in all these islands in order to meet the target of WHO’s End TB Strategy.


Keywords


Active case finding, Tuberculosis, Nicobar district

Full Text:

PDF

References


Corbett EL, Marston B, Churchyard GJ, De Cock KM. Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment. Lancet. 2006;367(9514):926–37.

Herbert N, George A, Baroness Masham of Ilton, Sharma V, Oliver M, Oxley A, et al. World TB Day 2014: finding the missing 3 million. Lancet. 2014;383(9922):1016–8.

World Health Organization. Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. Geneva: WHO; 2012.

Kranzer K, Afnan-Holmes H, Tomlin K, Golub JE, Shapiro AE, Schaap A, et al. The benefits to communities and individuals of screening for active tuberculosis disease: a systematic review. Int J Tuberc Lung Dis. 2013;17(4):432–46.

Getahun H, Raviglione M. Active case finding for TB in the community: time to act. Lancet. 2010.

Lonnroth K, Corbett E, Golub JE, Godfrey-Faussett P, Uplekar M, Weil D, et al. Systematic screening for active tuberculosis: rationale, definitions and key considerations. Int J Tuberc lung Dis. 2013;17: 289–98.

Obermeyer Z, Abbott-Klafter J, Murray CJL. Has the DOTS strategy improved case finding or treatment success? An empirical assessment. PLoS One. 2008;3:e1721.

Lönnroth K, Castro KG, Chakaya JM, Chauhan LS, Floyd K, Glaziou P, et al. Tuberculosis control and elimination 2010–50: cure, care, and social development. Lancet. Elsevier Ltd. 2010;375:1814–29.

Kranzer K, Afnan-Holmes H, Tomlin K, Golub JE, Shapiro A, Schaap A, et al. The benefits to communities and individuals of screening for active tuberculosis disease: a systematic review. Int J Tuberc Lung Dis. 2013;17:432–46.

Systematic screening for active tuberculosis: Principles and recommendations. World Health Organization, Geneva 2013.

Prasad BM, Satyanarayana S, Chadha SS, Das A, Thapa B, Mohanty S, et al. Experience of active tuberculosis case finding in nearly 5 million households in India. Public Health Action. 2016;6(1):15–8.

World Health Organization. Tuberculosis Fact sheet; 2016.

World Health Organization (WHO). End TB Strategy. Global Strategy and Targets for Tuberculosis Prevention, Care and Control After 2015; 2014O/HTM/TB/2015.19. Geneva (Switzerland); 2015.

Central Tuberculosis Division. Technical and Operational Guidelines on Treatment of Tuberculosis. New Delhi: Central Tuberculosis Division; 2016.

Mani M, Riyaz M, Shaheena M, Vaithiyalingam S, Anand V, Selvaraj K, et al. Is it feasible to carry out active case finding for tuberculosis in community-based settings? Lung India. 2019:36(1):28-31

Demissie M, Zenebere B, Berhane Y, Lindtjorn B. A rapid survey to determine the prevalence of smear-positive tuberculosis in Addis Ababa. Int J Tuberc Lung Dis. 2002;6:580–4.

Schuurman EMW, Srisaenpang S, Pinitsoontorn S, Bijleveld I, Vaeteewoothacharn K, Methapat C. The rapid village survey in tuberculosis control. Tuberc Lung Dis. 1996;77:549–54.

Myint O, Saw S, Isaakidis P, Khogali M, Reid A, Hoa NB, et al Active case-finding for tuberculosis by mobile teams in Myanmar: yield and treatment outcomes. Infectious Diseases of Poverty. 2017;6:77.