UCSF

Active TB screening outside of clinics and in communities may reduce undiagnosed TB disease.To determine yield of TB screening during community-based HIV testing campaigns (CHC) in seven rural Ugandan communities within an ongoing cluster randomized trial of universal HIV testing and treatment (SEARCH, NCT:01864603), we offered sputum microscopy to participants with prolonged cough (>2 weeks). We determined the number of persons needed to screen to identify one TB case, and the number of cases identified that linked to clinic and completed TB treatment.Of 36,785 adults enumerated in seven communities, 27,214 (74%) attended CHCs, and HIV testing uptake was >99%, with 941 (3.5%) HIV-infected adults identified. 5,786 (21%) adults reported cough, and 2,876 (11%) reported cough >2 weeks. Staff obtained sputum in 1,099/2,876 (38%) participants with prolonged cough, and identified 10 adults with AFB-positive sputum; 9 new diagnoses, and one known case already on treatment. The number needed to screen to identify one new TB case was 3,024 adults overall: 320 adults with prolonged cough, and 80 HIV-infected adults with prolonged cough.All nine newly diagnosed AFB+ participants linked to TB care within 2 weeks and initiated TB treatment.In a rural Ugandan setting, TB screening as an adjunct to large-scale, mobile HIV testing campaigns provides an opportunity to increase TB case detection.