{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:05:51Z","timestamp":1792069551890,"version":"4.4.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/P008011\/1"],"award-info":[{"award-number":["ES\/P008011\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000267","name":"Arts and Humanities Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000267","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department for Environment, Food and Rural Affairs"},{"name":"Veterinary Medicines Directorate"},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016237","name":"AHRI","doi-asserted-by":"publisher","award":["201433\/Z\/16\/Z"],"award-info":[{"award-number":["201433\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100016237","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tuberculosis (TB) case finding efforts typically target symptomatic people attending health facilities. We compared the prevalence of Mycobacterium tuberculosis (Mtb) sputum culture-positivity among adult clinic attendees in rural South Africa with a concurrent, community-based estimate from the surrounding demographic surveillance area (DSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinic: Randomly selected adults (\u226518 years) attending 2 primary healthcare clinics were interviewed and requested to give sputum for mycobacterial culture. Human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status were based on self-report and record review. Community: All adult (\u226515 years) DSA residents were invited to a mobile clinic for health screening, including serological HIV testing; those with \u22651 TB symptom (cough, weight loss, night sweats, fever) or abnormal chest radiograph were asked for sputum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinic: 2055 patients were enrolled (76.9% female; median age, 36 years); 1479 (72.0%) were classified HIV-positive (98.9% on ART) and 131 (6.4%) reported \u22651 TB symptom. Of 20\/2055 (1.0% [95% CI, .6\u20131.5]) with Mtb culture-positive sputum, 14 (70%) reported no symptoms. Community: 10\u2005320 residents were enrolled (68.3% female; median age, 38 years); 3105 (30.3%) tested HIV-positive (87.4% on ART) and 1091 (10.6%) reported \u22651 TB symptom. Of 58\/10\u00a0320 (0.6% [95% CI, .4\u2013.7]) with Mtb culture-positive sputum, 45 (77.6%) reported no symptoms. In both surveys, sputum culture positivity was associated with male sex and reporting &amp;gt;1 TB symptom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In both clinic and community settings, most participants with Mtb culture-positive sputum were asymptomatic. TB screening based only on symptoms will miss many people with active disease in both settings.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciab970","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T20:13:11Z","timestamp":1637352791000},"page":"314-322","source":"Crossref","is-referenced-by-count":18,"title":["Prevalence of<i>Mycobacterium tuberculosis<\/i>in Sputum and Reported Symptoms Among Clinic Attendees Compared With a Community Survey in Rural South Africa"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0598-7388","authenticated-orcid":false,"given":"Indira","family":"Govender","sequence":"first","affiliation":[{"name":"TB Centre, London School of Hygiene and Tropical Medicine , London , United Kingdom"},{"name":"Clinical Research Department, Africa Health Research Institute , Somkhele , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron 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