ArticlePublic health action2025
Active TB case finding in returnee coalminers and their home district communities in Pakistan.
Article in Public health action, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
settingFive districts with large coalmining workforces in Pakistan.
objectiveTo assess the burden of TB among returnee coalminers (RCMs) and associated community members (ACMs) in their home districts through active case finding (ACF).
designThis cross-sectional study (October 2020-September 2021) used portable chest X-ray (CXR) with artificial intelligence (AI) in camps and verbal screening in camps and communities. Individuals screening positive were tested with GeneXpert, and those diagnosed were initiated on TB treatment.
resultsA total of 150,242 individuals were screened, including 44% RCMs. Of these, 8.3% underwent CXR, 10% verbal screening in camps, and 81% verbal screening in communities. Symptoms were reported by 45% of RCMs and 15% of ACMs, while CXR abnormalities were comparable. TB was diagnosed in 226 RCMs and 204 ACMs, with overall prevalence per 100,000 of 341 (95% confidence interval [CI]: 296-385) and 243 (95% CI: 209-276), respectively. TB prevalence varied by screening strategy and was significantly higher among those screened with CXR: 1,156 in RCMs and 497 in ACMs.
conclusionAI-assisted CXR was substantially more effective than verbal screening, detecting significantly higher numbers of TB cases among RCMs and ACMs, supporting its use for targeted ACF in high-risk populations.
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