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Mobile van service may reduce TB incidence in Africa
Corbett EL. Lancet. 2010. doi:10.1016/S0140-6736(10)61425-0
Researchers using a mobile van detected more cases of tuberculosis than those using door-to-door methods in a cluster of neighborhoods in Zimbabwe, according to a study published online this week.
Smear-positive TB was noted in 255 of 5,466 participants in the mobile van group, compared with 137 of 4,711 smear-positive samples detected via door-to-door visits (adjusted risk, 1.48; 95% CI 1.11–1.96). During the course of the intervention period, prevalence of smear-positive TB declined across the two groups, from 6.5 per 1,000 adults to 3.7 per 1,000 adults.
The researchers targeted 46 neighborhoods in the high-density residential suburbs of Harare, Zimbabwe. The clusters were randomly assigned to receive six rounds of active TB case detection every six months. Adults aged 16 years old or older contributed two sputum specimens for flourescence microscopy analysis.
The researchers also analyzed a change in prevalence of culture-positive TB from before intervention to before the sixth round of intervention. The secondary analysis was conducted in a randomly-selected sample of 12% of the households from the two groups and was based on participants who had provided sputum in the earlier prevalence surveys.
The case notification rate was 2.8 per 1,000 adults per year in the 6- month period before the intervention began, the researchers noted.
“Wide implementation of active case finding, particularly with a mobile van approach, could have rapid effects on tuberculosis transmission and disease,” the researchers concluded. The study was funded by the Wellcome Trust.