Abstract:

Objective: To compare the epidemiological characteristics of pulmonary tuberculosis (PTB) patients detected through active versus passive case-finding in Zhejiang Province, China, during 2024, and to quantify the contribution of active detection to TB control. Methods: A retrospective cohort study was conducted using individual records from the China Disease Prevention and Control Information System in 2024. Demographic, temporal, spatial and clinical characteristics, as well as care-seeking interval, were compared between actively and passively detected cases with χ², one-way ANOVA and Kruskal-Wallis tests, as appropriate. Results: Of the 21764 PTB patients registered in 2024, 4977 (22.87%) were identified by active case-finding and 16787 (77.13%) through passive detection. Active detection accounted for a disproportionately large share of students/children (43.55%), people aged ≤14 years (44.75%) and ≥65 years (20.38%). The highest proportions of actively detected cases were observed in Shaoxing (29.73%), Ningbo (28.26%), Jiaxing (25.94%) and Quzhou (23.44%). The proportion of patients was higher in the second (24.15%) and third quarters (25.76%). The median (IQR) care-seeking interval was 11.00 (3.00, 29.00) days for actively detected cases, significantly shorter than the 19.00 (7.00, 40.00) days for passive detection. Conclusion: Active case-finding facilitates earlier diagnosis, shortening care-seeking delays, and preventing disease progression. Resource allocation should be optimized according to local TB epidemiological patterns and active case-finding should be strengthened in high-burden areas and among key populations.

Key words: Tuberculosis, pulmonary, Active detection, Passive detection, Epidemiologic study characteristics as topic, Zhejiang Province