Outpatient-department-based intensified tuberculosis case-finding activity in the tertiary care hospitals in West Bengal, India.: An observational study on the yields and outputs

Abstract

Background: Improved tuberculosis (TB) case detection using intensified case finding (ICF) is one of the cornerstones of the Stop TB Strategy. A Non-Government Organization (NGO)-led project took place in two tertiary care hospitals of West Bengal for outpatient department (OPD)-based ICF activities. Method: ology: A secondary analysis was conducted with the routinely collected project data to assess the yields of the model. Risk ratios have been calculated to identify associations of attrition before TB testing and diagnosis. Results: A total of 2324 presumptive TB patients (PTBP) were identified from a screening of 105,391 OPD attendees. The screening yield of PTBP was 2.2 % (2.1%–2.3 %). Total 143 TB patients were detected with testing of 770 (out of 2324 identified) presumptive cases. The pretesting attrition rate was 66.9 % (64.9%–68.8 %). The screening yield of TB was 0.14 % (0.11%–0.16 %).Being younger than fifteen years of age, of the Islam religion, a homemaker or unemployed was independently associated with “attrition before TB tests”.Being Hindu, a homemaker or a student was independently associated with “diagnosis with TB” among the tested. Conclusions: The OPD-based screening yield of TB is low. However, minimal resource requirements in this model advocate for its utility. Similar model can be replicated in other hospitals at low resource settings with appropriate setting-specific modifications.

Keywords

• Intensified TB case finding
• ICF
• OPD-Based ICF
• NGO-led TB screening model
• THALI project