Do active case-finding projects increase the number of tuberculosis cases notified at national level?

OBJECTIVE: To analyse the impact of active tuberculosis case finding (ACF) projects on the number of sputum smear-positive (SS+) tuberculosis (TB) cases notified at national level.

METHODS: Case-finding results of the 16 countries that participated in the first wave of the TB REACH project were analysed. Information on the number of SS+ TB cases at national level were taken from the 2014 World Health Organization global tuberculosis report. A segmented linear regression model was used to analyse trends in notification.

RESULTS: An increase in SS+ TB cases from 3% to 334% was observed in the areas of intervention of the TB REACH project in almost all countries. There were no significant increases in the number of SS+ TB cases notified at the national level in most countries, except in two countries during the intervention period (Benin and Kenya), and in one country after the intervention period (Somalia).

CONCLUSIONS: The TB REACH project had no impact on SS+ TB cases notified at national level in almost all countries during and after the intervention. ACF projects are pilot studies that are often difficult to reproduce at national level due to their high cost and the lack of human resources.