INTERVENTION TO INCREASE TUBERCULOSIS CASE DETECTION THROUGH COMMUNITY ENGAGEMENT AND CONTACT SCREENING IN SINDH PAKISTAN.

Background: The escalating risk of Tuberculosis (TB) transmission among household contacts necessitates a comprehensive analysis of Multidrug-Resistant (MDR) and Drug-Susceptible (DS) TB cases through early screening and intervention. This cross-sectional survey-based study, conducted in the Larkana district of Sindh, Pakistan, from January to August 2021, aimed to assess and address the prevalence of MDR and DS-TB among household contacts. Methods: Verbal screening was the initial step, involving the collection of information such as symptoms, age, gender, and relation to the index case. Individuals identified through verbal screening underwent further testing, including molecular testing using GeneXpert and smear testing. The study population comprised 830 household contacts, with 100 associated with MDR-TB and 370 with DS-TB. Results: Among the 830 household contacts, 92% of cases were confirmed as DS-TB, while 7% were identified as MDR-TB. Cough emerged as the predominant symptom, constituting 51% of MDR-TB and 54% of DS-TB cases. All confirmed cases were recommended for treatment, and preventive awareness sessions were conducted by health professionals. The study, while limited by the reliance on verbal screening data, represents a significant contribution to the evidence base for screening household contacts of TB in the Sindh province of Pakistan. Conclusion: The findings underscore the urgency of early detection and intervention in household contacts to mitigate the spread of TB, particularly MDR-TB. Despite the limitations of verbal screening, the study emphasizes the importance of targeted screening programs and preventative measures. This research contributes valuable insights to the ongoing efforts to manage TB in the Sindh province, highlighting the need for comprehensive strategies to address both DS and MDR-TB cases within household settings.