RT Journal Article SR Electronic T1 Active TB case finding strategies in high-risk groups in low-incidence countries - A literature review JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 3530 VO 42 IS Suppl 57 A1 Dominik Zenner A1 Jo Southern A1 Rob van Hest A1 Gerard deVries A1 Helen R. Stagg A1 Delphine Antoine A1 Ibrahim Abubakar YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/3530.abstract AB IntroductionMost cases of Tuberculosis (TB) in low incidence countries arise in high-risk groups, such as migrants, or social risk groups. Increasingly, active case finding (ACF) initiatives amongst these groups are promoted in these settings. The aim of the review was to summarise the evidence for ACF interventions in low incidence countries.MethodsWe conducted a search on Medline (1966-2012), using a defined search strategy, to find ACF papers amongst social risk groups and migrants in low incidence countries and hand-searched reference lists of included papers and reviews.ResultsWe included 27 of 578 papers for social risk groups, and 7 of 198 papers not included in a recent systematic review (Klinkenberg, 2008).For social risk groups, the majority of studies (17 of 27) reported ACF in homeless persons, with a median of 726 (range 120-22,000) screenees, a median of 9.5 (range 0-313) detected cases and a yield of 0-6.0%. Other ACF settings included prisons (9 studies, median 11,576 screenees, yield 0.01-2.7%) and the drug user population (n=2). Among migrant studies, the overall median yield was 0.34% (a similar level to the 0.35% in the 2008 systematic review and 0.31% in the newer studies). Pre-entry screening had a significantly higher yield (1.21%).DiscussionDespite the lack of randomised controlled trials, our review of observational studies demonstrated effectiveness of highly targeted interventions in high-risk groups. Further research to determine the best strategies for ACF in low incidence countries, and on the cost effectiveness of ACF, is needed.