Introduction Tuberculosis (TB) was the leading cause of death from an infectious illness globally with an estimated 10.4 million new cases and 1.4 million deaths in 2015. In Ghana, from the 2013 TB prevalence survey conducted by the National Tuberculosis Control Programme, the incidence is estimated as 165 per 100,000 population and a mortality rate of 7.5 per 1,000 infected people. The Tuberculosis surveillance system is part of the general framework of the Integrated Disease Surveillance and Response. This evaluation was to assess whether the system is meeting its set objectives, assess its usefulness and describe its attributes. Methods The TB surveillance system of the Ashaiman municipality was evaluated using Centre for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems 2006. Records review from 2014 to 2016 was done to assess objectives of the system and surveillance data source of 2016 was used to assess attributes. Interviews were conducted at the various levels using semi-structured questionnaire and data analysis done with Epi info 7 and Microsoft Excel to run frequencies and percentages. Results The surveillance system is well structured with standardized data collection tools. The system was found to be useful, though it just partially met its objectives. It was also found to be simple, flexible and fairly stable with average timeliness. It had low acceptability and is not geographically representative. It had low sensitivity of 45/100,000 and a low predictive value positive of 6.6%. Conclusion The surveillance system was found to be useful but partially met its objectives. There is the need to improve the sensitivity, predictive value positive timeliness and acceptability.

Background Tuberculosis (TB) remains a major public health threat in Ghana. The impact of COVID-19 resulted in a 15% decline of TB case notification in 2020 compared to 2019. To mitigate the impact on TB services, the Ghana National Tuberculosis Programme (NTP) introduced the bidirectional screening and testing for TB and COVID-19 in 2021. Objective To evaluate the yield of bidirectional screening and testing for TB and COVID-19 among facility attendees in the Greater Accra region. Method We used secondary data obtained from the initial implementation stage of the bidirectional testing for TB and COVID-19 among COVID-19 and/or TB presumed cases in five health facilities in the Greater Accra Region from January to March 2021. To mitigate the impact of COVID-19 on TB services and accelerate TB case detection, the NTP of Ghana introduced bidirectional screening and testing for TB and COVID-19 in Greater Accra Region before scaling up at national level. Results A total of 208 presumed TB or COVID-19 cases were identified: 113 were tested for COVID-19 only, and 94 were tested for both TB and COVID-19, 1 was tested for TB only. Among presumed cases tested for COVID-19, 9.7% (95% CI, 5.6-13.7%) were tested positive. Whilst among the total presumed tested for TB, 13.7% (95% CI, 6.8-20.6%) were confirmed to have TB. Among the total 94 presumed cases tested for both TB and COVID-19, 11.7% (95% CI, 5.2-18.2%) were confirmed to have TB and 13.8% (95% CI, 6.9-20.8%) participants were COVID-19 positive and one participant (1.1%) had both COVID-19 and TB. Conclusion Bidirectional screening and testing for TB and COVID-19 shows significant potential for improving overall case detection for the two diseases. The bidirectional screening and testing could be applicable to address a similar respiratory epidemic in the future that might have a masking effect on the response to TB disease.

No abstract

Background: Tuberculosis (TB) remains a major public health threat in Ghana. The impact of COVID-19 resulted in a 15% decline of TB case notification in 2020 compared to 2019. To mitigate the impact on TB services, the Ghana National Tuberculosis Programme (NTP) introduced the bidirectional screening and testing for TB and COVID-19 in 2021. Objective: To evaluate the yield of bidirectional screening and testing for TB and COVID-19 among facility attendants in the Greater Accra region. Method: We used secondary data obtained from the initial implementation stage of the bidirectional testing for TB and COVID-19 among COVID-19 and/or TB presumed cases in five health facilities in the Greater Accra Region from January to March 2021. Results: A total of 208 presumed cases were identified: 113 were tested for COVID-19 only, and 94 were tested for both TB and COVID-19, 1 was tested for TB only. Among presumed cases tested for COVID-19, 9.7% (95% CI, 5.6%-13.7%) were tested positive. Whilst among the total presumed tested for TB, 13.7% (95% CI, 6.8%-20.6%) were confirmed to have TB. Among the total 94 presumed cases tested for both TB and COVID-19, 11.7% (95% CI, 5.2%-18.2%) were confirmed to have TB and 13.8% (95% CI, 6.9%-20.8%) participants were COVID-19 positive and one participant (1.1%) had both COVID-19 and TB. Conclusion: Bidirectional screening and testing for COVID-19 and TB among facility attendants yielded a higher proportion of TB and COVID-19 cases. Bidirectional screening and testing for TB and COVID-19 shows significant potential for improving overall case detection for the two diseases. The bidirectional screening and testing could be applicable to address similar respiratory epidemic in the future that might have a masking effect for TB case detection.

No abstract