Impact of Active Case Finding on Treatment Outcomes in Adult Pulmonary Tuberculosis Patients
The objective: to assess the effect of active finding of tuberculosis cases on the frequency of bacterial excretion, lung tissue destruction, and treatment outcomes. Subjects and Methods. The characteristics of adult patients (newly detected - new cases and those with relapsed pulmonary tuberculosis) were studied in 2 phases: a) 1,404 cases, including 814 actively found, at detection; b) the outcomes of the completed first course of chemotherapy in 946 patients, including 565 actively detected, registered for treatment in 2017 and 2018. Adjusted relative risk (aOR) and statistical significance of differences were calculated. Results. Patients detected actively versus those detected by self presentation to a medical unit had a lower level of positive results of smear microscopy (aOR = 2.7; p < 0.01) and lung tissue destruction (aOR = 1.4; p = 0.01), but the level of positive culture was equal (aOR = 0.9; p = 0.6). Active case finding had no effect on treatment failure rate but if a patient is HIV negative and young, it reduced the risk of death in tuberculosis patients during treatment (aOR = 0.3; p < 0.01). Active case finding, along with no history of previous treatment, negative HIV status, and older age were inversely associated with treatment interruption (aOR = 0.3; p < 0.01).