Community health volunteers’ contribution to Tuberculosis patients notified to National Tuberculosis program in Kenya

Abstract

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.