Demonstrating the prevalence of pulmonary TB in local neighborhoods by conducting a door-to-door survey. Results of this study indicated the importance of utilizing local healthcare resources

The World Health Organization (WHO) estimates that one-third of the world's population is currently infected with the TB bacillus (WHO website 6/12/007). In the state of Oaxaca, the coastal region has the second highest incidence of Pulmonary Tuberculosis (TB), just behind the Isthmus region, with hot spots such as the San Pedro Mixtepec neighborhood. From 2003 onwards, the Oaxacan Public Health Department has been reporting over 100 new cases per year of Pulmonary TB, with outbreaks of the illness being particularly prevalent in the neighborhoods of Benito Juarez and San Miguel.

There has been considerable concern about variant strands of TB developing and gaining a foothold in different pockets throughout the world. One of the single most important approaches to dealing with this situation is to establish baseline data with which to compare current rates of TB prevalence and, from that, to be able to measure and to target preventative strategies, particularly around stemming the growth of Multi Drug Resistant (MDR) strands.

Given the poor hygiene, dilapidated housing and concerns over the nutritional conditions of these two neighborhoods on top of the prevalence of TB in these neighborhoods over the last three years, the medical team decided to focus on tracking the prevalence of pulmonary TB in these neighborhoods from January 1st, 2006 to December 31st, 2006. The team was led by CFHI Medical Director in Puerto Escondido, Dr. Pastrana Vasquez.

The main objective of this initiative was to demonstrate the prevalence of pulmonary TB in the neighborhoods of Benito Juarez and San Miguel (Puerto Escondido) within the local population of those aged 15 years or older. In order to achieve this objective, the team conducted a large-scale door-to-door survey to discover those who had an 'active'cough. From this data, the team could compare their statistics with the official government statistics. This was significant because this type of data had never been measured proactively due to lack of resources, with the result that the government figures only measured the instances of pulmonary TB according to those who had presented at a clinic to receive testing.

From January 1st to November 30th, 2006, 1005 sputum samples were analyzed from 307 patients. 29% of the samples tested positive. Close to 50% of Pulmonary TB cases were identified through this study that had not been previously identified in government studies.

This indicates the importance of targeting healthcare resources at the local level, specifically, at the neighborhood level, in order to prevent MDR TB strains from developing.