Success of active tuberculosis case detection among high-risk groups in urban slums in Pakistan.

BACKGROUND In Pakistan, patients with symptoms suggestive of tuberculosis (TB) seek care from a wide array of health care providers, many of whom do not notify cases to the National TB Programme (NTP). SETTING We evaluated an active case detection intervention in five randomly selected districts in urban slums of Sindh Province, Pakistan. OBJECTIVE To evaluate the increase in case notification of smear-positive TB by active case finding at community-based chest camps by engaging the private providers. DESIGN A cross-sectional study of TB case detection associated with a project using integrated intervention and chest camps. RESULTS From April 2011 to September 2012, the total number of clients seen in the camps was 165 280. Of all the attendees, 13 481 (12.7%) were examined by sputum smear microscopy. The proportion of smear-positive results was significantly higher among those from engaged private providers than among those referred from camps (OR 1.54, 95%CI 1.42-1.66). During the project, the total number of smear-positive TB notifications increased over the intervention period from 5158 to 8275. CONCLUSION Active case detection by engaging private providers and chest camps can significantly increase the number of smear-positive TB case notifications.