Passive detection of tuberculosis (TB) cases may lead to delay in treatment which may contribute to increased severity of disease and mortality. Active case finding may be an alternative. In a community survey in Cape Town, South Africa, we actively detected 27 bacteriologically positive TB cases and compared those with 473 passively detected TB cases. Seven of 27 (26%) actively detected TB cases did not start treatment within 2 months and were considered initial defaulters. Those who did start treatment had similar treatment success rates as passively detected TB cases (both 80%) (OR 1̇01, 95% CI 0·33-3·09). Passively detected cases reported the presence of the symptoms cough (OR 3·72, 95% CI 1·47-9·39), haemoptysis (OR 3·20, 95% CI 1·03-9·93), night sweats (OR 3·35, 95% CI 1·40-7·99), fever (OR 4·28, 95% CI 1·21-15·14), and weight loss (OR 11·14, 95% CI 4·17-29·74) more often than those detected actively. We conclude that although TB cases detected by a community survey are less symptomatic and are prone to a high initial default rate, active case finding can potentially identify a substantial portion of the existing caseload at an earlier stage of disease, thereby reducing the risk of transmission. © 2008 Copyright © 2008 Cambridge University Press.
CITATION STYLE
Den boon, S., Verver, S., Lombard, C. J., Bateman, E. D., Irusen, E. M., Enarson, D. A., … Beyers, N. (2008). Comparison of symptoms and treatment outcomes between actively and passively detected tuberculosis cases: The additional value of active case finding. Epidemiology and Infection, 136(10), 1342–1349. https://doi.org/10.1017/S0950268807000106
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