Identifying and mapping the target population for ACF campaign

A targeted approach is considered as an appropriate public health response to identify the hidden cases of TB in the communities. In this regard the National TB Elimination Programme (NTEP) expects that 110,000 per million vulnerable population (11%) should be mapped for community-based screening and >90% of the mapped target vulnerable population should be screened for symptoms of TB.

Mapping of target population from the identified vulnerable population helps the programme to screen out the persons into: 1) those who are at high risk of progression to active TB disease; 2) those who are eligible for TB preventive treatment 3) Enhance the cost-effectiveness of the programme

Following are various methods for identifying and mapping the target population from the vulnerable population:

• Tuberculosis symptom screening

• Sputum testing

• Chest X-ray

Various modalities used to conduct mapping of target population from the identified vulnerable population under the ACF campaign are:

a) House-to-house TB symptom interviews through community volunteers

• Relatively minimal costs

• Needs community awareness session as a pre requisite before conducting ACF

• May be affected by self and perceived stigma

• Community volunteers may require monetary/ no monetary incentives.

b) Door-to-door Sputum collection / sputum drop-off clinics

• Has the potential for higher yield of TB cases

• Involvement of Trained TB staff is required for appropriate collection of sputum

• The sputum has to be non-contaminated in order to avoid compromising the results.

c) Conducting Camps in prisons, migrant localities, old age homes and other such institutional settings

• Accessible to the population who are at high risk but otherwise have limited access to TB testing services

• Essential to detect TB early and stop the spread of infection in such institutional settings.

• Requires skilled TB staff in such settings

d) Mobile vans equipped with X-ray units and Truenat machines

• Feasible yet resource-intensive modality

• Requires skilled staff to handle the testing

• Requires resources - electricity, internet, computer/ tablet etc.

Image

Resource 

• Optimizing active case finding for tuberculosis, Implementation lessons from South-East Asia, World Health Organization,2021.

• Burugina Nagaraja, S.; Thekkur, P.; Satyanarayana, S.; Tharyan, P.; Sagili, K.D.; Tonsing, J.; Rao, R.; Sachdeva, K.S. Active Case Finding for Tuberculosis in India: A Syntheses of Activities and Outcomes Reported by the National Tuberculosis Elimination Programme. Trop. Med. Infect. Dis. 2021, 6, 206. https://doi.org/10.3390/ tropicalmed6040206

Assessment