Background: Contact investigation is important in finding contacts of people who have Tuberculosis (TB) disease so that they can be given treatment and stop further transmission. The main objective of this study was to assess the contribution of community health volunteers (CHVs) to the number of TB patients notified to the National program in Kenya through household contact screening and referral of persons with TB signs and symptoms to the facilities for further investigation. Methods: This was a retrospective desk review of project reports submitted to Amref Health Africa in Kenya by the sub-recipients implementing activities in the 33 counties with Case Notification Rate (CNR) of less 175/100,000 and Treatment Success Rate (TRS) of less than 88% as per the National strategic plan 2015-2018. Data for this study covered a period between January and December 2016. Data on the notified TB patients was obtained from the National Tuberculosis Information Basic Unit (TIBU). The study population included all the TB index cases whose households were visited by CHVs for contact screening. Data was recorded into excel spreadsheets where the descriptive analysis was done, proportions calculated and summarized in a table. Results: Community health volunteers visited a total of 26,307 TB patients (index cases) in their households for contact screening. A total of 44,617 household members were screened for TB with 43,012 (96.40%) from households of bacteriologically confirmed TB patients and 1606 (3.60%) from households of children under 5 years. The proportion of the persons referred to the number screened was 19.6% for those over 5 years and 21.9% from under 5 years with almost the same percentages for males and females at 19.2% and 19.7% respectively. The percentage of (TB) cases identified through tracing of contacts in these counties improved to 10% (5456) of the 54, 913 cases notified to the National TB Program. Conclusions: This study showed that in the 33 counties of Global Fund TB project implementation, the percentage of TB cases identified through tracing of contacts improved from 6 to 10% while the percentage of notified TB cases; all forms contributed through community referrals improved from 4 to 8%. Community health volunteers can play an effective role in household contact screening and referrals for the identification of TB.
The Horizons Program, in partnership with International Medical Corps (IMC) and Steadman Research Services International (SRSI), conducted an intervention study in Kibera, an urban slum in Nairobi, to determine what effect three different community-based activities had on utilization of key prevention of mother-to-child transmission (PMTCT) services. The interventions included moving services closer to the population via mobile clinics, as well as increasing psychosocial support through the use of traditional birth attendants (TBAs) and peer counselors as PMTCT promoters. Researchers used a pre-/post-test evaluation 4-cell design (three experimental intervention arms and a comparison arm with no additional community activities) to assess the outcomes of the pilot project. Each arm corresponded to a distinct sub-area of the Kibera slum. At baseline (June 2004), a total of 1,803 women took part in exit interviews at the clinics. In October and November 2004, researchers conducted in-depth interviews to further explore issues raised in the quantitative survey. The convenience sample included 24 HIV-positive women and five HIV-negative women with infants aged 10 weeks or younger. These women were selected from the four study arms. Interviews were conducted in Kiswahili, recorded, transcribed, and then translated into English.
Background Contact investigation is important in finding contacts who have Tuberculosis (TB) disease so that they can be given treatment and stop further transmission. The main objective of this study was to assess the contribution of community health volunteers (CHVs) to the number of TB patients notified to the National program in Kenya. The specific objectives were to establish the total number of households of TB index cases visited by CHVs for contact screening, identify the total number of household members screened for TB and establish the number of persons referred for further TB investigation and the number identified with TB. Methods This was a retrospective desk review of project reports submitted to Amref Health Africa in Kenya by the sub recipients implementing activities in the 33 counties with Case Notification Rate (CNR) of less 175/100,000 and Treatment Success Rate (TRS) of less than 88% as per the National strategic plan 2015-2018. Data for this study covered a time period between January and December 2016. Data on the notified TB patients was obtained from the National Tuberculosis Information Basic Unit (TIBU). The study population included all the TB index cases whose households were visited by CHVs for contact screening. Data was analyzed descriptively. Results CHVs visited a total of 26,307 TB patients in their households for contact screening. A total of 44,617 household members were screened for TB with 43,012 (96.40%) coming from households of bacteriologically confirmed TB patients and 1,606 (3.60%) from households of children under 5 years. The proportion of the persons referred in relation to number screened was 19.6% for those over 5 years and 21.9% from under 5 years with almost the same percentages for male and female at 19.2% and 19.7% respectively Conclusions This study showed that in the 33 counties of Global Fund TB project implementation the percentage of TB cases identified through tracing of contacts improved from 6% to 10% while the percentage of notified TB cases; all forms contributed through community referrals improved from 4% to 8%. CHVs play an effective role in household contact screening and referrals for identification of TB.
Background Contact investigation is important in finding contacts who have Tuberculosis (TB) disease so that they can be given treatment and stop further transmission. The main objective of this study was to assess the contribution of community health volunteers (CHVs) to the number of TB patients notified to the National program in Kenya. The specific objectives were to establish the total number of households of TB index cases visited by CHVs for contact screening, identify the total number of household members screened for TB and establish the number of persons referred for further TB investigation and the number identified with TB.Methods This was a retrospective desk review of project reports submitted to Amref Health Africa in Kenya by the sub recipients implementing activities in the 33 counties with Case Notification Rate (CNR) of less 175/100,000 and Treatment Success Rate (TRS) of less than 88% as per the National strategic plan 2015-2018. Data for this study covered a time period between January and December 2016. Data on the notified TB patients was obtained from the National Tuberculosis Information Basic Unit (TIBU). The study population included all the TB index cases whose households were visited by CHVs for contact screening. Data was analyzed descriptively.Results CHVs visited a total of 26,307 TB patients in their households for contact screening. A total of 44,617 household members were screened for TB with 43,012 (96.40%) coming from households of bacteriologically confirmed TB patients and 1,606 (3.60%) from households of children under 5 years. The proportion of the persons referred in relation to number screened was 19.6% for those over 5 years and 21.9% from under 5 years with almost the same percentages for male and female at 19.2% and 19.7% respectivelyConclusions This study showed that in the 33 counties of Global Fund TB project implementation the percentage of TB cases identified through tracing of contacts improved from 6% to 10% while the percentage of notified TB cases; all forms contributed through community referrals improved from 4% to 8%. Community health volunteers can play an effective role in household contact screening and referrals for identification of TB.
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