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Background <p>Tuberculosis (TB) case detection in China predominantly relies on passive case finding (PCF). To evaluate the effectiveness of active case finding (ACF), a retrospective analysis of routine surveillance data from ACF programs implemented among individuals aged 65 years and older in Quzhou from 2020 to 2022 was conducted. However, Comparative studies evaluating these two strategies remain limited. This study analyzes the basic characteristics of ACF and PCF, evaluates the impact of ACF on diagnostic delay and treatment outcomes, and provides evidence-based support for optimizing TB control strategies.</p> Methods <p>Data on pulmonary tuberculosis cases and related variables among individuals aged 65 years and older in Quzhou City from 2020 to 2022 were collected from the Tuberculosis Management Information System. The primary outcomes were diagnostic delay and treatment outcome. Cox regression and multivariate logistic regression were used to assess the influence of different case-detection methods on these outcomes.</p> Results <p>During the study period, 2,383 pulmonary tuberculosis cases aged 65 years and older were registered in Quzhou City. Of these, 23.25% were identified through ACF. The median diagnostic delay (i.e., ≥ 28 days) in the ACF group was 17 days (Inter Quartile Range, [IQR]:7–36), which was significantly shorter than 24 days (IQR:10–55) observed in the PCF group. ACF was associated with a shorter time to diagnosis (adjusted hazard ratio [aHR]: 1.502, 95% confidence interval [CI]: 1.360–1.658). Both ACF (adjusted odds ratio, [AOR]: 1.658, 95%CI: 1.218–2.258) and absence of diagnostic delay (AOR: 1.57, 95%CI: 1.242–1.986) were associated with higher treatment success rates. Increasing age (AOR: 0.913, 95%CI: 0.898–0.928) was significantly associated with lower treatment success rate.</p> Conclusion <p>Compared with PCF, ACF is associated with shorter diagnosis times and a higher treatment success rate. To improve the effectiveness of tuberculosis prevention and treatment, screening strategies should be optimized to reach vulnerable populations and comprehensive management should extend from early detection to successful treatment.</p>

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Comparison of active and passive case finding on diagnostic delay and treatment outcomes in older patients with pulmonary tuberculosis: a cohort study using real-world data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月26日

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  • Qingxiu Yan,
  • Wei Wang,
  • Xing Zhang,
  • Yu Gao,
  • Ping Zhu,
  • Min Wang,
  • Hana Yu,
  • Xiaogang Hao,
  • Chunfu Fang

摘要

Background

Tuberculosis (TB) case detection in China predominantly relies on passive case finding (PCF). To evaluate the effectiveness of active case finding (ACF), a retrospective analysis of routine surveillance data from ACF programs implemented among individuals aged 65 years and older in Quzhou from 2020 to 2022 was conducted. However, Comparative studies evaluating these two strategies remain limited. This study analyzes the basic characteristics of ACF and PCF, evaluates the impact of ACF on diagnostic delay and treatment outcomes, and provides evidence-based support for optimizing TB control strategies.

Methods

Data on pulmonary tuberculosis cases and related variables among individuals aged 65 years and older in Quzhou City from 2020 to 2022 were collected from the Tuberculosis Management Information System. The primary outcomes were diagnostic delay and treatment outcome. Cox regression and multivariate logistic regression were used to assess the influence of different case-detection methods on these outcomes.

Results

During the study period, 2,383 pulmonary tuberculosis cases aged 65 years and older were registered in Quzhou City. Of these, 23.25% were identified through ACF. The median diagnostic delay (i.e., ≥ 28 days) in the ACF group was 17 days (Inter Quartile Range, [IQR]:7–36), which was significantly shorter than 24 days (IQR:10–55) observed in the PCF group. ACF was associated with a shorter time to diagnosis (adjusted hazard ratio [aHR]: 1.502, 95% confidence interval [CI]: 1.360–1.658). Both ACF (adjusted odds ratio, [AOR]: 1.658, 95%CI: 1.218–2.258) and absence of diagnostic delay (AOR: 1.57, 95%CI: 1.242–1.986) were associated with higher treatment success rates. Increasing age (AOR: 0.913, 95%CI: 0.898–0.928) was significantly associated with lower treatment success rate.

Conclusion

Compared with PCF, ACF is associated with shorter diagnosis times and a higher treatment success rate. To improve the effectiveness of tuberculosis prevention and treatment, screening strategies should be optimized to reach vulnerable populations and comprehensive management should extend from early detection to successful treatment.