Assessing TB case-finding
Objectives: at the end of the assessment reviewers should comment on –
- Whether there is universal access to TB diagnosis;
- The approaches used to identify people with TB;
- The measures that need to be taken to improve case-finding.
TB case-finding may be passive or active. Passive case-finding requires that affected individuals are aware of their symptoms, have access to health facilities, and are evaluated by health workers or volunteers who recognize the symptoms of TB and who have access to a reliable laboratory. Patients with symptoms compatible with TB are usually identified in health facilities, and all health workers and volunteers should be aware of the symptoms of TB, and how to proceed if TB is suspected. Health workers should also be aware of the circumstances in which a patient must be assessed for potentially drug-resistant TB.
Active case-finding requires systematic screening and clinical evaluation of persons who are at high risk of developing TB, such as people who are contacts of someone who was diagnosed with TB or people living with HIV. The use of active case-finding assumes that (i) groups at high risk for TB are clearly defined, (ii) procedures to screen and assess individuals belonging to these groups are well established, and (iii) health professionals and community workers who should be involved in implementing these procedures have been clearly identified.
Specialized and non-specialized outpatient clinics at health facilities, peripheral health centres, village health posts and in the community
Staff to be met:
Health-care workers (such as doctors, nurses, medical assistants and clinical officers) as well as community-based health workers and volunteers