Systematic screening of pulmonary tuberculosis among HIV high risk groups in two districts of Chhattisgarh: a feasibility study

Background: HIV is an important risk factor for the development of tuberculosis. People living with HIV are 21-34 times more likely to develop TB than their uninfected counterparts. Efficient approach for detecting more cases along with shortened duration of infectivity involves a systematic screening of pulmonary TB in settings where high risk groups are concentrated even before the diagnosis HIV infection. Lack of proper screening strategy for HRGs might result in their exclusion from timely intervention which may prove lethal without treatment.Methods: A cross sectional study was carried out in two districts of Chhattisgarh during September-December 2019.Training cum sensitization sessions were conducted for peer educators, outreach workers, counselors and project managers prior to the survey and were trained for systematic screening of pulmonary TB, sputum collection and transportation to GeneXpert®MTB/RIF lab and other relevant data collection for pulmonary TB diagnosis.Results: A total of 3963 HRGs were intended to be included in the study, 3418 were screened with 86.2% compliance rate. Out of all HRGs screened (3418), 81 (2.4%) were found presumptive pulmonary TB, of them 2 (0.05%) were microbiologically confirmed, 5 cases were found with incomplete treatment (all were IDUs). Prevalence of tobacco use, alcohol use, diabetes and hypertension were observed in 5.3% and 7.2%, 1.2% and 1.1 respectively.Conclusions: Although yield for pulmonary TB in this study was not much, the study has demonstrated that active case finding for accessing such a hidden population through existing manpower can assure better acceptability and feasibility in resource poor settings.