Active screening for pulmonary tuberculosis among migrant workers and their families residing in Puducherry

TB remains a major public health challenge worldwide, with India contributing nearly one-fourth of the global TB burden. Migrant workers face barriers to healthcare access, delayed diagnosis, and poor health-seeking behavior. Active case finding (ACF) among high-risk populations is essential for early detection and reducing transmission. To identify pulmonary TB among migrant workers and their families and explore their perceptions of TB symptoms, transmission, and barriers to accessing care. A cross-sectional quantitative study with an embedded qualitative component was conducted in Puducherry between January and December 2021. A census sampling strategy was used. Participants were screened using a pretested tool, and those with presumptive TB underwent sputum CBNAAT testing or chest X-rays if needed. Free-listing exercises were used to assess perceptions and barriers. Of 403 participants screened (mean age: 29.7 ± 10.6 years; 84.6% male), 21 (5.2%, 95% CI: 3.0–8.2) were identified as presumptive TB. Fourteen underwent sputum CBNAAT testing, all negative. Seven declined testing due to workplace-related scheduling constraints. Cough, fever, headache, and haemoptysis were the most commonly recognized symptoms. Workplace restrictions and lack of supervisor approval were key barriers to care. ACF is vital for detecting undiagnosed TB among migrant workers. Workplace-focused interventions and awareness campaigns are needed to improve screening adherence and reduce diagnostic delays.