Intensified pulmonary tuberculosis case finding among selected high-risk clinical groups attending secondary level public health care facilities in Bhubaneswar

BACKGROUND: Intensified case finding is meant for early detection of Tuberculosis cases to achieve a rapid decline in burden, morbidity and mortality for elimination of TB. METHODOLOGY: This study was carried out among patients of 5 high-risk groups attending public health care facilities in Odisha to detect TB cases. 20% (1500) women attending antenatal clinics, 20% (1500) elderly patients, 20% (1500) patients admitted in medical/pulmonary ward, 20% (1500) patients with diabetes and 20% (1500) people living with HIV/AIDS were included in the study. The role of chest X-ray screening and molecular TB diagnostic testing were evaluated. RESULTS: In all, 7500 participants were screened throughout the study period, 2020-21. Maximum 6981 (93%) were recruited from Capital Hospital, Bhubaneswar and only 6.9% were recruited from DHH, Khordha. Culture, microscopy, MGIT, TrueNAT using sputum samples and X-ray was carried out for patients enrolled in the study. 6% (103) of elderly, 9% (135) of those admitted in the wards and 10% (157) of PLHIV were having signs and symptoms of TB. 0.7% each of hospitalized patients and PLHIV, 0.3% of elderly and 0.1% of patients with Diabetes were positive. Out of 7500, 548 (7.31%) participants were screened positive and 29 (0.39%) tested positive for TB. The yield of active TB case finding was 0.39%, with the highest yield observed among PLHIV and hospitalized patients. They were referred to NTEP for initiation of treatment. CONCLUSIONS: PLHIV, elderly and hospitalized patients, emerged as the risk groups for TB in this region. It is feasible to screen patients from the high risk groups along with the routine health system.