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Abstract
SettingSouth Africa has the third highest tuberculosis (TB) burden in the world. Intensified case finding, recommended by WHO, is one way to control TB.ObjectiveTo evaluate the effectiveness and acceptability of a paper slip method for TB contact tracing.MethodTB patients were offered paper slips to give to their contacts, inviting them for TB screening. The number of contacts screened and the proportion diagnosed with TB was calculated. Contacts that returned to the clinic after receiving the slips were interviewed. A focus group discussion (FGD) with TB patients was held to determine their acceptability.ResultsFrom 718 paper slips issued, a 26% TB contact tracing rate was found, with a 12% case detection rate. The majority (68%) of contacts were screened within 2 weeks of receiving the slip. Age and gender were not significantly associated with time to screening. 16% of the contacts screened did not reside with the TB patients. 98% of the contacts said the method was acceptable. FGD findings show that this method is acceptable and may prevent stigma associated with TB/HIV.ConclusionThis simple, inexpensive method yields high contact tracing and case detection rates and potentially would yield additional benefits outside households.
Highlights
Over the last two decades, the rate of tuberculosis (TB) in South Africa has been on the increase [1]
Case finding can be either passive or active. The former refers to screening people that present themselves to a healthcare facility for problems unrelated to TB whilst the latter involves actively going out into the community to look for cases
This study aimed to evaluate the effectiveness of the paper slip method for TB contact tracing by determining the contact tracing rate, the case detection rate among contacts and the acceptability of this method to both TB patients and their contacts
Summary
Over the last two decades, the rate of tuberculosis (TB) in South Africa has been on the increase [1]. The country is among the twenty two high TB burden countries in the world [2]. The WHO recommends the “3Is” for the control of TB: infection control, intensified case finding and isoniazid preventive therapy [3,4]. Case finding can be either passive or active. The former refers to screening people that present themselves to a healthcare facility for problems unrelated to TB whilst the latter involves actively going out into the community to look for cases. Active case finding has been shown to yield more TB cases than passive case finding [5]
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