Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups – The Romanian Experience

Abstract

Beatrice Mahler,1– 3 Dragoș Băiceanu,3,4 Alexandru Stoichiță,1– 3 Dragoș Dendrino,3 Mihaela Mihai,3,5 Gina Ciolan,2 Elmira Ibraim,3,4 Ioana Munteanu,2,3,6 Cristina Popa,2,3 Mădălina Burecu,2,3 Paula Rusu,3 Andreea Cioacată,2 Ioana Mădălina Moșteanu,2,7 Antonela Dragomir1– 3 1Pneumology II Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 2Pneumology Clinic, “Marius Nasta” Institute of Pneumology, Bucharest, Romania; 3Tuberculosis Screening Program, “Marius Nasta” Institute of Pneumology, Bucharest, Romania; 4Research Department, “Marius Nasta” Institute of Pneumology, Bucharest, Romania; 5Faculty of Economic Cybernetics, Statistics and Informatics, The Bucharest University of Economic Studies, Bucharest, Romania; 6Faculty of Medicine, “Titu Maiorescu” University, Bucharest, Romania; 7Faculty of Medicine, University of Medicine and Pharmacy Craiova, Craiova, RomaniaCorrespondence: Dragoș Băiceanu; Alexandru Stoichiță, “Marius Nasta” Institute of Pneumology, 90 Viilor Street, Bucharest, 050159, Romania, Tel [phone], Email [email protected]; [email protected]: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas.Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests.Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1).Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions.Keywords: active screening, vulnerable populations, socio-demographic analysis, GeneXpert, intervention health strategies, tuberculosis

Keywords

• active screening
• vulnerable populations
• socio-demographic analysis
• genexpert
• intervention health strategies
• tuberculosis