{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T23:33:47Z","timestamp":1773876827592,"version":"3.50.1"},"reference-count":32,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2026,1,6]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Since 2017, India\u2019s TB programme is implementing active case finding (ACF) in high-risk populations in all districts. Symptom screening followed by confirmatory testing was the ACF algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine differences in pre-treatment delays and severe illness at diagnosis between ACF- and passive case finding (PCF)-detected adults with drug-sensitive pulmonary TB in high-risk populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>Cross-sectional analytical study from 28 randomly sampled districts across India (2023). Post-triaging, severe illness was defined as presence of very severe undernutrition, respiratory insufficiency, or poor performance status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 790 enrolled, 426 were ACF-detected and 364 PCF-detected. ACF-detected adults were significantly older (mean 47.1 year vs 43.9 year), lived farther from diagnosis facilities (median 8 km vs 6 km), had lower formal education exposure (52% vs 37% with no formal education), lower household income (\u20b920,000 vs \u20b924,000 annual per capita), and experienced fewer health care provider visits (median 1 vs 2). Pre-treatment delay from symptom onset to treatment initiation (median 46 days in both groups) and burden of severe illness (39% vs 34%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.180) were similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Though ACF linked the vulnerable to care and reduced health care provider visits, this did not translate into early detection. High burden of severe illness at diagnosis is a concern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/pha.25.0044","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:09:03Z","timestamp":1773850143000},"page":"47-53","source":"Crossref","is-referenced-by-count":0,"title":["Does active case finding detect TB early in programme settings? 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