Digital tools not enough; quality control-linked incentives needed for TB active case-finding
Year: 2026
Type: article
Abstract: Low yield from tuberculosis active case-finding (ACF) within routine health systems remains a significant concern. In Udaipur district, a recent ACF cycle (December 2025–January 2026) was implemented using the Community Health Integrated Platform, following identification of high-risk populations through an annual digital household survey. Although 70.6% of the 1.3 million high-risk population was reportedly screened, only 44 tuberculosis cases were detected (test positivity: 0.6%), resulting in a very high number needed to screen (NNS) of 21,082 and a low yield of 0.7%. However, telephonic cross-verification revealed substantial discrepancies: the actual screening coverage was estimated at just 35% (457,240 individuals), and only one of the 44 reported cases could be confidently attributed to ACF, increasing the estimated NNS to 457,240 and reducing yield to less than 0.1%. Similarly poor outcomes were observed in multidimensionally poor and locally identified high-risk villages. These findings highlight that digital tools alone are insufficient to ensure effective ACF implementation; instead, integrating quality-control-linked incentives is essential to improve data reliability, accountability, and overall program impact.
Source: Figshare
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7141975397