Does intensified case finding increase tuberculosis case notification among children in resource-poor settings? A report from Nigeria

Oshi, Daniel C.; Chukwu, Joseph N.; Nwafor, Charles C.; Meka, Anthony O.; Madichie, Nelson O.; Ogbudebe, Chidubem; Onyeonoro, Ugochukwu Uchenna; Ikebudu, Joy; Ekeke, Ngozi; Anyim, Moses C.; Ukwaja, Kingsley Nnanna; Aguwa, Emmanuel N.

doi:10.1016/j.ijmyco.2015.10.007

Cited by 34 publications

(40 citation statements)

References 9 publications

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“…Studies from Pakistan, India, Nepal and Nigeria have shown that intensified case finding can result in large increases in childhood TB case notification [9,[13][14][15]. Our study indicates that injection of new resources through focused active TB case finding and contact tracing efforts can substantially raise the baseline TB case notification among children.…”

Section: Discussionmentioning

confidence: 61%

The Impact of Funding on Childhood TB Case Detection in Pakistan

Malik

Hussain²,

Creswell³

et al. 2019

TropicalMed

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This study is a review of routine programmatically collected data to describe the 5-year trend in childhood case notification in Jamshoro district, Pakistan from January 2013 to June 2018 and review of financial data for the two active case finding projects implemented during this period. The average case notification in the district was 86 per quarter before the start of active case finding project in October 2014. The average case notification rose to 322 per quarter during the implementation period (October 2014 to March 2016) and plateaued at 245 per quarter during the post-implementation period (April 2016 to June 2018). In a specialized chest center located in the district, where active case finding was re-introduced during the post implementation period (October 2016), the average case notification was 218 per quarter in the implementation period and 172 per quarter in the post implementation period. In the rest of the district, the average case notification was 160 per quarter in the implementation period and 78 during the post implementation period. The cost per additional child with TB found ranged from USD 28 to USD 42 during the interventions. A continuous stream of resources is necessary to sustain high notifications of childhood TB.

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Section: Discussionmentioning

confidence: 61%

The Impact of Funding on Childhood TB Case Detection in Pakistan

Malik

Hussain²,

Creswell³

et al. 2019

TropicalMed

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“…Consequently, a shift from passive to active case DOI: 10.4236/aid.2018.84016 finding approach is crucial to improve TB case detection in Nigeria [24]. [25] maintained that adopting and implementing active case search as part of national policy is essential for finding missing cases of TB.…”

Section: Current Strategies To End Tbmentioning

confidence: 99%

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

Onuka¹,

Okezie²,

Agboola³

et al. 2018

AID

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Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Nigeria is one of the countries with high incidence and prevalence of TB. The late and low case detection has been a major problem with National TB control program, caused by passive case finding strategy practiced by the country. A shift from the passive and active case search has been recommended for detection of missing cases of TB and improved program performance. The proximity of TB contact is a major determinant of disease transmission. However, maximizing early case detection and prompt treatment of notified cases is very useful in (TB) control especially in high burden countries. The tracking of TB contacts provides a good platform for early diagnosis, educating the household on TB disease and infection control as well as breaking the chain of transmission. The objective of the study is to ascertain effectiveness of contact tracing on Tuberculosis case detection. The study is a retrospective quasi experimental with quantitative arm. The study was conducted in Abia State, one of the South Eastern States of Nigeria. A pre-tested questionnaire was used for data collection and analyzed with SPSS. A total of 168 and 162 index cases of TB were recruited for both intervention and control facilities.

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“…The World Health Organization (WHO) and Stop TB Partnership have called for a paradigm shift on how TB services are organised, moving from passive to active case finding -particularly in key populations facing higher risk of TB (2)(3)(4)(5). Furthermore, both agencies specify that TB testing and treatment services must reach at least 90% of these key populations by 2020 (5)(6)(7). Addressing barriers to TB service delivery among key populations is therefore critical to the overall goal of ending the TB epidemic (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…In 2017, only about 24% of the estimated incident cases of TB in the country were notified [1]. To address this, a number of systematic TB screening strategies have been carried out in Nigeria targeting the general population, TB contacts, persons living with HIV (PLHIV), children, urban and mobile populations (6)(7)(8)(9)(10). In Nigeria's riverine areas, limited land mass leads to uneven distribution of health facilities in the area and residents require costly marine transport -where a return trip may cost up to US$30 to access appropriate health services (11).…”

Section: Introductionmentioning

confidence: 99%

Investigating Barriers and Challenges to Tuberculosis Service Delivery in Hard-to-Reach Riverine Areas: A Mixed-Methods Study in the Niger Delta Region of Nigeria

Alphonsus¹,

Chukwu²,

Pande³

et al. 2020

Preprint

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Background Little is known about the challenges and barriers to tuberculosis (TB) service delivery in hard-to-reach riverine populations in Nigeria. The missing TB cases in such key populations need to be found if the End TB targets are to be met. This study explored perceptions and attitudes related to TB, as well as the level of diagnostic and treatment delays in communities of the riverine Niger Delta.Methods This was an exploratory mixed-methods study carried out in two states (Bayelsa and Delta) situated in the Niger Delta region in Nigeria. It consisted of quantitative surveys of community members and TB patients, FGDs with community members and KIIs with health care workers.Results The questionnaire survey was completed by 597 community members (51.6% female) and 51 TB patients (56.9% female); 73 community members and 15 HCWs participated in FGDs and interviews respectively. Community members’ mean [SD] knowledge and attitude scores were 6.1/10 [2.2] and 4.8/12 [1.9] respectively. Older age (>40y) (p=0.04) and regular income (p<0.001) were independent predictors of TB knowledge. Good TB knowledge (aOR 2.5; 95% C.I. 1.5 – 4.4) and formal education (aOR 5.8; 95% C.I. 1.3 – 25.6) were associated with positive TB attitudes. Patients’ TB knowledge was similar at 6.8/8 [1.5]. Most (98.8%) respondents took >1 hour to access the nearest diagnostic centre. Mean patient-related and health system-related diagnostic delays were 16.3 and 3.7 weeks respectively. Mean treatment delay was found to be 0.5 weeks. Patient-related, financial, cultural and structural barriers were found to delay TB diagnosis and treatment in this environment. Belief in faith healing and herbal remedies, transport barriers, and negative HCW attitudes were prominent themes in FGDs. Problems transporting sputum samples and tracing mobile communities were primary HCW complaints.Conclusions A number of barriers affect TB service delivery in hard-to-reach riverine communities in Nigeria. Our study suggests that an appropriately designed community intervention can improve TB service delivery in these communities. The main focus will be to address information asymmetry between service providers and the community, empower affected communities to find cases, engage informal providers such as patent medicine vendors, and strengthen the health system.

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Does intensified case finding increase tuberculosis case notification among children in resource-poor settings? A report from Nigeria

Abstract: Intensified case finding combined with capacity building, provision of work aids/guidelines, and TB health education can improve childhood-TB notification.

Cited by 34 publications

References 9 publications

The Impact of Funding on Childhood TB Case Detection in Pakistan

The Impact of Funding on Childhood TB Case Detection in Pakistan

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

Investigating Barriers and Challenges to Tuberculosis Service Delivery in Hard-to-Reach Riverine Areas: A Mixed-Methods Study in the Niger Delta Region of Nigeria

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