Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 20;82(1):92.
doi: 10.1186/s13690-024-01326-0.

A mixed-methods study on impact of active case finding on pulmonary tuberculosis treatment outcomes in India

Akshat P Shah  1 , Jigna D Dave  2 , Mohit N Makwana  1   3 , Mihir P Rupani  4   5 , Immad A Shah  6
Affiliations

A mixed-methods study on impact of active case finding on pulmonary tuberculosis treatment outcomes in India

Akshat P Shah et al. Arch Public Health. .

Abstract

Background: Tuberculosis (TB) remains a significant public health burden in India, with elimination targets set for 2025. Active case finding (ACF) is crucial for improving TB case detection rates, although conclusive evidence of its association with treatment outcomes is lacking. Our study aims to investigate the impact of ACF on successful TB treatment outcomes among pulmonary TB patients in Gujarat, India, and explore why ACF positively impacts these outcomes.

Methods: We conducted a retrospective cohort analysis in Gujarat, India, including 1,638 pulmonary TB cases identified through ACF and 80,957 cases through passive case finding (PCF) from January 2019 to December 2020. Generalized logistic mixed-model compared treatment outcomes between the ACF and PCF groups. Additionally, in-depth interviews were conducted with 11 TB program functionaries to explore their perceptions of ACF and its impact on TB treatment outcomes.

Results: Our analysis revealed that patients diagnosed through ACF exhibited 1.4 times higher odds of successful treatment outcomes compared to those identified through PCF. Program functionaries emphasized that ACF enhances case detection rates and enables early detection and prompt treatment initiation. This early intervention facilitates faster sputum conversion and helps reduce the infectious period, thereby improving treatment outcomes. Functionaries highlighted that ACF identifies TB cases that might otherwise be missed, ensuring timely and appropriate treatment.

Conclusion: ACF significantly improves TB treatment outcomes in Gujarat, India. The mixed-methods analysis demonstrates a positive association between ACF and successful TB treatment, with early detection and prompt treatment initiation being key factors. Insights from TB program functionaries underscore the importance of ACF in ensuring timely diagnosis and treatment, which are critical for better treatment outcomes. Expanding ACF initiatives, especially among hard-to-reach populations, can further enhance TB control efforts. Future research should focus on optimizing ACF strategies and integrating additional interventions to sustain and improve TB treatment outcomes.

Keywords: Active case finding; India; National TB elimination program; Passive case finding; TB program functionaries; TB treatment outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Selection of patients notified with pulmonary TB in the public sector in Gujarat during 2019–2020
Fig. 2
Fig. 2
Perceptions of TB program functionaries on active case finding (ACF) and TB treatment outcomes during January-April 2023 in Gujarat
See this image and copyright information in PMC

References

    1. World Health Organization . Global tuberculosis report 2023. 2023.
    1. Central TB Division (Ministry of Health & Family Welfare) India TB report 2023. New Delhi: Government of India; 2023.
    1. World Health Organization . Global tuberculosis report 2022. Geneva: World Health Organization; 2022.
    1. Central TB Division (Ministry of Health and Family Welfare. Government of India). India TB report 2022, coming together to end TB altogether. New Delhi; 2022. Available from: https://tbcindia.gov.in/WriteReadData/IndiaTBReport2022/TBAnnaulReport20....
    1. Central TB Division (Ministry of Health & Family Welfare) National strategic plan for tuberculosis elimination 2017–2025. New Delhi: Government of India; 2017.

LinkOut - more resources