Abstract: Objective To explore a feasible approach to increase case detection of tuberculosis through intensive referral and tracing of TB suspects and patients between hospital and TB dispensary.Methods An operational research was conducted in 3 cities and 38 jurisdiction counties sampled by non-probability,and a strategic referral and tracing system between hospitals/clinics and TB dispensary was developed upon the local situation in Hunan province of China.One-year monitoring of referral,tracing and diagnosis of TB suspects and cases data was used to assess the outcomes of the project implementation.Comparisons of the case detection and notification of new smear-positive tuberculosis were made between the project year and the previous year,project areas and non-project areas.Results Among 126 public general hospitals/clinics in 38 project counties,124 hospitals referred a mean of 10 TB suspects and cases to TB dispensary monthly.Comparing with the previous year,the initial consultation rate of TB suspects increased 102.1%;the referral of TB suspects from hospitals/clinics to TB dispensary increased 5 times a total of 10596 new smear-positive PTB cases were identified and the notification of new smear positive PTB increased by 112.9% from 27.12/100000 in the previous year to 57.71/100000 in the project year,a significantly higher than non-project area,whose notification was 38.77/100000.Conclusions Intensive referral and tracing of TB suspects and patients between hospital and TB dispensary is a feasible and effective approach to increase case detection.Strengthening administrative intervention and incentive mechanism are essential to achieve the project objectives.

Key words: tuberculosis, pulmonary/prevention and control