Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups – The Romanian Experience.

aim,^3,4 Ioana Munteanu,^2,3,6 Cristina Popa,^2,3 Mădălina Burecu,^2,3 Paula Rusu,³ Andreea Cioacată,² Ioana Mădălina Moșteanu,^2,7 Antonela Dragomir^{1– 31}Pneumology II Department, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; ²Pneumology Clinic, "Marius Nasta" Institute of Pneumology, Bucharest, Romania; ³Tuberculosis Screening Program, "Marius Nasta" Institute of Pneumology, Bucharest, Romania; ⁴Research Department, "Marius Nasta" Institute of Pneumology, Bucharest, Romania; ⁵Faculty of Economic Cybernetics, Statistics and Informatics, The Bucharest University of Economic Studies, Bucharest, Romania; ⁶Faculty of Medicine, "Titu Maiorescu" University, Bucharest, Romania; ⁷Faculty of Medicine, University of Medicine and Pharmacy Craiova, Craiova, Romania Correspondence: Dragoș Băiceanu; Alexandru Stoichiță, "Marius Nasta" Institute of Pneumology, 90 Viilor Street, Bucharest, 050159, Romania, Tel +4 0749 574 412, Email [email protected] ; [email protected] Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions. [ABSTRACT FROM AUTHOR]