Setting: Community based five pulmonary tuberculosis (PTB) surveys among adults.
Objectives: Estimate sensitivity and specificity of screening tools for PTB and sputum microscopy.
Methods: For each survey site, we estimated sensitivity and specificity of different screening criteria and microscopy against culture; pooled estimates were obtained using Random Effects Model.
Results: Sensitivity of cough alone, screening for any symptom (persistent cough ≥2 weeks, fever or chest pain ≥1 month, hemoptysis), any symptom or history of anti-TB treatment (h/o ATT) were 56.2%, 66% and 71.2% respectively; specificities were 95.3%, 93.8% and 92.7% respectively. X-ray when used alone for primary screening had sensitivity and specificity of 76.6% and 97.3% respectively. When used along with screening for cough, these figures were 94.3% and 93.1%, and 100% and 97.3% when used with any symptom and h/o ATT. When used for secondary screening, sensitivity and specificity of X-ray was 66.8% and 87.8% respectively after primary screening for cough, 65.0% and 89.8% after screening for any symptom, and 67.1% and 86.7% when used after screening for any symptom or h/o ATT. Pooled sensitivity and specificity of smear was 46.2% and 99.3% respectively.
Conclusion: Program managers may use these estimates while evaluating algorithms for active case finding.
Keywords: Chest radiograph; India; Primary screening; Secondary screening; Symptoms.
Copyright © 2018 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.