Background Systematic screening is a potential tool for reducing the prevalence of tuberculosis (TB) and counteracting COVID-19-related disruptions in care. Repeated community-wide screening can also measure changes in the prevalence of TB over time. Methods We conducted serial, cross-sectional TB case finding campaigns in one community in Kampala, Uganda, in 2019 and 2021. Both campaigns sought sputum for TB testing (Xpert MTB/RIF Ultra) from all adolescents and adults. We estimated the prevalence of TB among screening participants in each campaign and compared characteristics of people with TB across campaigns. We simultaneously enrolled and characterised community residents who were diagnosed with TB through routine care and assessed trends in facility-based diagnosis. Results We successfully screened 12 033 community residents (35% of the estimated adult/adolescent population) in 2019 and 11 595 (33%) in 2021. In 2019, 0.94% (95% CI: 0.77% to 1.13%) of participants tested Xpert positive (including trace). This proportion fell to 0.52% (95% CI: 0.40% to 0.67%) in 2021; the prevalence ratio was 0.55 (95% CI: 0.40 to 0.75)). There was no change in the age (median 26 vs 26), sex (56% vs 59% female) or prevalence of chronic cough (49% vs 54%) among those testing positive. By contrast, the rate of routine facility-based diagnosis remained steady in the 8 months before each campaign (210 (95% CI: 155 to 279) vs 240 (95% CI: 181 to 312) per 100 000 per year). Conclusions Following an intensive initial case finding campaign in an urban Ugandan community in 2019, the burden of prevalent TB as measured by systematic screening had decreased by 45% in 2021, despite the intervening COVID-19 pandemic. Data are available upon reasonable request.

中文翻译：

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在乌干达城市社区开展密集的病例发现活动和 COVID-19 大流行后，结核病患病率下降

背景 系统筛查是降低结核病 (TB) 患病率和应对与 COVID-19 相关的护理中断的潜在工具。社区范围内的重复筛查还可以衡量结核病患病率随时间的变化。方法 我们于 2019 年和 2021 年在乌干达坎帕拉的一个社区开展了一系列横断面结核病病例发现活动。这两项活动均从所有青少年和成人中收集痰液进行结核病检测 (Xpert MTB/RIF Ultra)。我们估计了每次活动中筛查参与者的结核病患病率，并比较了各活动中结核病患者的特征。我们同时招募并描述了通过常规护理诊断出结核病的社区居民，并评估了基于设施的诊断趋势。结果 我们在 2019 年成功筛查了 12 033 名社区居民（占估计成人/青少年人口的 35%），在 2021 年成功筛查了 11 595 名社区居民（占 33%）。2019 年，0.94%（95% CI：0.77% 至 1.13%）的参与者接受了测试Xpert 阳性（包括痕迹）。2021年这一比例下降至0.52%（95% CI：0.40%至0.67%）；患病率为 0.55（95% CI：0.40 至 0.75））。检测呈阳性的人的年龄（中位数 26 岁 vs 26 岁）、性别（女性 56% vs 59%）或慢性咳嗽患病率（49% vs 54%）没有变化。相比之下，在每次活动前的 8 个月内，基于常规设施的诊断率保持稳定（每年每 10 万人中有 210 例（95% CI：155 至 279） vs 240 例（95% CI：181 至 312））。结论 2019 年在乌干达城市社区开展了密集的初步病例发现活动后，尽管出现了 COVID-19 大流行，但通过系统筛查测得的结核病流行负担在 2021 年下降了 45%。数据可根据合理要求提供。