ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Impact of Community-Wide Tuberculosis Active Case Finding and Human Immunodeficiency Virus Testing on Tuberculosis Trends in Malawi.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Genomic epidemiology ofMicrobial genomics · 2026Article
- Reported Tuberculosis Symptoms: An Inadequate Classifier of Disease State.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Assessing three-decade HIV testing transformation: TOPSIS-radar evaluation of tiered health system performance in rural-urban Southwestern China.BMC public health · 2025Article
- Clinically diagnosed tuberculosis and mortality in high burden settings: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Health and economic impacts of Vaccae vaccination incorporating active case finding in India and South Africa: a modelling study.BMJ public health · 2024Article
- Finding the missed millions: innovations to bring tuberculosis diagnosis closer to key populations.BMC global and public health · 2024Review
- Integrated plasma proteomics identifies tuberculosis-specific diagnostic biomarkers.JCI insight · 2024Article
- Community-based active-case finding for tuberculosis: navigating a complex minefield.BMC global and public health · 2024Review
- Article
- Impact of active case-finding for tuberculosis on case-notifications in Blantyre, Malawi: A community-based cluster-randomised trial (SCALE).PLOS global public health · 2023Article
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Abstract
backgroundTuberculosis case-finding interventions are critical to meeting World Health Organization End TB strategy goals. We investigated the impact of community-wide tuberculosis active case finding (ACF) alongside scale-up of human immunodeficiency virus (HIV) testing and care on trends in adult tuberculosis case notification rates (CNRs) in Blantyre, Malawi.
methodsFive rounds of ACF for tuberculosis (1-2 weeks of leafleting, door-to-door enquiry for cough and sputum microscopy) were delivered to neighborhoods ("ACF areas") in North-West Blantyre between April 2011 and August 2014. Many of these neighborhoods also had concurrent HIV testing interventions. The remaining neighborhoods in Blantyre City ("non-ACF areas") provided a non-randomized comparator. We analyzed TB CNRs from January 2009 until December 2018. We used interrupted time series analysis to compare tuberculosis CNRs before ACF and after ACF, and between ACF and non-ACF areas.
resultsTuberculosis CNRs increased in Blantyre concurrently with start of ACF for tuberculosis in both ACF and non-ACF areas, with a larger magnitude in ACF areas. Compared to a counterfactual where pre-ACF CNR trends continued during ACF period, we estimated there were an additional 101 (95% confidence interval [CI] 42 to 160) microbiologically confirmed (Bac+) tuberculosis diagnoses per 100 000 person-years in the ACF areas in 3 and a half years of ACF. Compared to a counterfactual where trends in ACF area were the same as trends in non-ACF areas, we estimated an additional 63 (95% CI 38 to 90) Bac + diagnoses per 100 000 person-years in the same period.
conclusionsTuberculosis ACF was associated with a rapid increase in people diagnosed with tuberculosis in Blantyre.
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