Evidence presented at the 50th Union World Conference on Lung Health shows that household based active case finding – whereby health workers proactively seek out people who have been exposed to tuberculosis (TB) – could help achieve the global “end TB” commitment to reduce TB deaths by 95 percent and to cut new cases by 90 percent by 2035.
In Friday’s oral abstract session, Active TB case finding: one size does not truly fit all, Thomas Gachie of the Zambia AIDS Related Tuberculosis Project (Zambart) reported findings from the PopART trial, in which community health providers visited all households within a community to offer HIV testing and TB symptom screening. Those who reported symptoms of TB gave sputum samples for testing and were linked to care if necessary. In three rounds of screening, 78.7 percent, 79 percent and 79.9 percent of people diagnosed with TB began treatment, with the yield being approximately twice as high for men than women, showing that household-based, community-wide universal HIV testing and TB screening in high-HIV prevalence settings can improve TB detection within communities at greatest risk of TB.
Recently published results from the PopART trial, which was led by researchers at the London School of Hygiene and Tropical Medicine, provide evidence that the approach was successful in reducing rates of HIV in the study communities in Zambia and South Africa. The TREATS study is now underway to assess the impact of PopART on TB prevalence and incidence in those communities. These results will help to inform new methods to eliminate TB and HIV in high burden countries.