Table 1 Potential benefits and harms to populations, health services, and individuals from TB active case finding programmes
From: Community-based active-case finding for tuberculosis: navigating a complex minefield
Potential benefits | Potential harms | |
|---|---|---|
Populations and health services | • Reduced TB transmission • Reduced TB incidence • Improved TB case detection • Reduced TB mortality • Integration of other health, surveillance, and development programmes | • Repeated rounds of intrusive and inconvenient programmes • Potentially draw resources from other health priorities and programmes if not carefully designed and implemented • Overburdened/overstretched health workforce • Potential loss of focus on primary healthcare strengthening and universal healthcare access due to “vertical approach” |
Individuals and households | • Earlier TB diagnosis and treatment • Reduced sickness and debility from TB and post-TB sequalae • Potentially reduced care seeking/household catastrophic costs • Opportunity to increase knowledge/awareness/behaviours around TB • Receipt of other health programmes co-delivered with ACF (e.g. HIV, viral hepatitis, leprosy, non-communicable diseases) • Improved quality of life | • False positive TB diagnosis, necessitating unnecessary TB treatment • Potential to increase stigmatisation within communities and neighbourhoods • Uncertain benefit of TB prevention programmes for some population groups (e.g. TB preventive therapy) |