Active case finding: understanding the burden of tuberculosis in rural South Africa.

Pronyk, PM; Joshi, B; Hargreaves, JR; Madonsela, T; Collinson, MA; Mokoena, O; Tollman, SM; Hausler, HR; (2001) Active case finding: understanding the burden of tuberculosis in rural South Africa. The international journal of tuberculosis and lung disease, 5 (7). pp. 611-8. ISSN 1027-3719

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SETTING: The Agincourt demographic and health surveillance site in South Africa's rural Northern Province. OBJECTIVES: To accurately assess the true burden of tuberculosis in a rural sub-district with a known high prevalence of human immunodeficiency virus. DESIGN: Data on hospital registrations of tuberculosis were combined with data from an ongoing demographic health and surveillance system to accurately describe the burden of tuberculosis in a well-defined community. Undiagnosed active cases of sputum-positive disease in the community were detected among chronic coughers identified by heads of household during a single-pass census interview. RESULTS: The incidence of hospitalised tuberculosis among the permanently resident population (n = 56 566) was 212/100,000 person-years during 1999. The average point prevalence of detected tuberculosis (all forms) among patients aged over 10 years was 133/100,000, and 81/100,000 for sputum-positive pulmonary disease. This compares with a point prevalence of 16/100,000 cases of sputum-positive disease detected through active case finding. CONCLUSION: For every nine cases of sputum positive pulmonary tuberculosis being treated at any one time, there are two cases of undiagnosed disease in the community. This study demonstrates a modest burden of undiagnosed tuberculosis among residents in a rural sub-district in South Africa.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Research Centre: Centre for Evaluation
TB Centre
PubMed ID: 11467367
Web of Science ID: 169673300004


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