Can Screening People Registering With Primary Care Improve the Detection of Tuberculosis?

This randomised controlled trial tests whether screening people registering with general practices cost-effectively increases the detection of tuberculosis. The study objectives are to: 1. recruit, and randomise with stratification, forty Hackney general practices to usual activity or screening for TB primarily during registration health checks (by practice nurses and GPs) and transfer-in visits for children (by health visitors) 2. implement a screening programme comprising education, resources and clinical support for intervention practices using proven behaviour change strategies 3. gather outcomes and costs 4. build research capacity within an ELENoR Primary Care Research Team and across a Primary Care Trust. The primary outcome is the proportion of TB cases identified in primary care. The study is powered to detect a 20% increase (from 55% to 75%) in the detection of new cases of TB in primary care with 80% power at the 5% significance level. Secondary outcomes are rates of prophylaxis for latent TB infection (LTBI), BCG immunisation, smear negative (early) TB and costs. Analyses will be by intention to treat.