Integrating tuberculosis screening into annual health examinations for the rural elderly improves case detection.

OBJECTIVE

To assess the feasibility and effects of identifying tuberculosis (TB) cases by integrating TB screening into routine health examinations for the elderly in rural China.

METHODS

Three counties in Shandong Province were randomly selected for TB screening among three groups of elderly individuals (aged ⩾60 years) at high risk for TB: 1) those with symptoms of TB, 2) patients with type 2 diabetes mellitus (DM), and 3) close contacts of TB cases. Individuals with X-rays suggestive of TB were referred to the county TB dispensary for further investigation.

RESULTS

Among the 93 094 elderly residents who underwent health examinations, 9044 (9.7%) were identified as high risk for TB. TB detection rates were 0.87 per 1000 among those who showed TB symptoms only and 3.36/1000 among those with DM only; however, the rate was significantly higher (115/1000) among those who had both DM and TB symptoms. No TB cases were identified from the close contacts group.

CONCLUSION

Integrating TB screening into annual health examinations for the elderly in rural areas was effective in identifying new cases, especially among elderly DM patients with TB symptoms.