Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups The Romanian Experience

Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions. Keywords: active screening, vulnerable populations, socio-demographic analysis, GeneXpert, intervention health strategies, tuberculosis