Key Terms & Concepts — UPSC Mains
Active Case Finding (TB)
"A proactive public health strategy where health workers systematically screen high-risk populations for tuberculosis instead of waiting for patients to seek care"
Active Case Finding (ACF) is an epidemiological strategy in tuberculosis (TB) control where healthcare workers proactively screen targeted populations — including household contacts of TB patients, residents of urban slums, tribal communities, prison inmates, people living with HIV, malnourished children, and migrant labourers — using symptom screening, chest X-rays, and molecular diagnostics (CB-NAAT/TrueNat), rather than relying on passive case detection where patients self-report to health facilities. ACF is critical for identifying the 'missing millions' — TB patients who are undiagnosed, unreported, or untreated.
India bears the world's highest TB burden (approximately 27% of global cases, ~27.8 lakh estimated incidence in 2023) and has set an ambitious target of TB elimination by 2025 — five years ahead of the global SDG target of 2030. Active case finding is a cornerstone of the National Strategic Plan for TB Elimination (2017-2025) and is tested under GS2 (health policy, governance) and GS3 (science — diagnostics technology).
- 1 India's National TB Elimination Programme (NTEP, renamed from RNTCP in 2020) uses ACF through the Ni-kshay Poshan Yojana and Ni-kshay Mittra initiatives
- 2 ACF uses a cascade — symptom screening, followed by chest X-ray (including AI-powered portable digital X-ray), then confirmatory testing via CB-NAAT (Cartridge-Based Nucleic Acid Amplification Test) or TrueNat
- 3 Passive case detection misses an estimated 30-40% of TB cases in India — these undiagnosed cases continue to transmit the disease in the community
- 4 India's TB notification rate improved from 14.2 lakh (2019) to over 25 lakh (2023), largely due to expanded ACF drives
- 5 The Pradhan Mantri TB Mukt Bharat Abhiyan (launched September 2022) engages community volunteers (Ni-kshay Mitras) to support TB patients with nutrition and treatment adherence
- 6 WHO recommends ACF as a key intervention for TB elimination in high-burden countries, alongside preventive therapy for latent TB
- 7 Drug-resistant TB (MDR-TB and XDR-TB) requires specialised ACF protocols as these cases are harder to diagnose and more expensive to treat (Rs 6-9 lakh per MDR-TB patient vs Rs 5,000 for drug-sensitive TB)
During the TB Harega Desh Jeetega campaign, health workers in Mumbai conducted door-to-door active case finding in Dharavi slum, screening over 5 lakh residents using portable X-ray vans and on-the-spot TrueNat testing — detecting hundreds of previously undiagnosed TB cases who would have otherwise continued spreading the disease.