Shrivastava Saurabh Rambiharilal, Shrivastava Prateek Saurabh
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, Tamil Nadu, India.
J Res Health Sci. 2013 May 29;13(1):19-23.
Tuberculosis (TB) continues to pose a major global health problem and thus intensive action is needed to control and ultimately eliminate the disease.
An active case finding (ACF) survey was conducted in the urban slum areas of the R-South Municipal Ward of Mumbai City for a period of two months from June to July 2012. Micro planning for survey was done by District Tuberculosis Officer and Medical Officer of Health of R-South ward. The entire health post staffs of R-South ward were trained to perform the survey. TB suspects were identified by trained community health volunteers during their home to home visit. These suspects were referred to the designated microscopy centers (DMCs) for sputum examination and those diagnosed with TB were put on anti-TB treatment.
A total of 278 TB suspects were identified on enquiring on the presence of symptoms suggestive of TB. Out of them 221(79.5%) patients got tested for sputum examination. Sputum positive TB was diagnosed in 29 suspects and the sputum positivity rate was 13.1%, which was slightly higher than the passive case finding norms of 10% as prescribed under Revised National TB Control Program.
Active case finding for tuberculosis in the general community was discouraged for several decades because of high costs of implementation. However, results of the survey suggest that periodic ACF should be incorporated in populations wherever tuberculosis incidence / prevalence is high as there was a definite improvement in the case detection rate.
结核病仍然是一个重大的全球健康问题，因此需要采取密集行动来控制并最终消除该疾病。
于2012年6月至7月期间，在孟买市R南区市政病房的城市贫民窟地区进行了一项主动病例发现（ACF）调查，为期两个月。由地区结核病官员和R南区卫生官员进行调查的微观规划。R南区病房的全体卫生站工作人员都接受了进行调查的培训。经过培训的社区卫生志愿者在逐户家访期间识别出结核病疑似患者。这些疑似患者被转介到指定的显微镜检查中心（DMC）进行痰检，那些被诊断为结核病的患者开始接受抗结核治疗。
在询问是否存在提示结核病的症状时，共识别出278名结核病疑似患者。其中221名（79.5%）患者进行了痰检。在29名疑似患者中诊断出痰涂片阳性结核病，痰涂片阳性率为13.1%，略高于《修订的国家结核病控制规划》规定的10%的被动病例发现标准。
由于实施成本高昂，几十年来一直不鼓励在普通社区进行结核病主动病例发现。然而，调查结果表明，在结核病发病率/患病率较高的人群中应定期开展主动病例发现，因为病例检出率有了明显提高。
