National population-based tuberculosis prevalence survey in Ghana, 2013

Bonsu, Frank; Addo, Kwasi Kennedy; Alebachew, Zeleke; Gyapong, John; Badu-Peprah, Augustina; Gockah, R; Hanson-Nortey, Nii Nortey; Law, Irwin; Tadolini, Marina; Onozaki, Ikushi; Sismanidis, Charalampos; Owusu‐Dabo, Ellis

doi:10.5588/ijtld.19.0163

Cited by 17 publications

(14 citation statements)

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“…In general males are more at risk for TB in Ghana and other countries and our study findings are in line with this [22,29]. It is reported that in illegal artisanal small-scale mining settings in Ghana, women may constitute up to 50% of the labour force and play various roles [16,30,31].…”

Section: Plos Onesupporting

confidence: 89%

“…In case, a significant proportion of those missed were miners, given the higher risk of TB among miners, it could be possible that our results may be an underestimation of the TB burden in AMC studied [18]. The prevalence of TB among the people screened in the artisanal mining communities in this study was more than two and half times what was reported for the general population in Ghana in the TB prevalence survey (356 bacteriologically confirmed TB per 100,000), on the face value re-iterating the data on the higher risk of TB among mining communities [9,18,22].…”

Section: Plos Onementioning

confidence: 64%

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Case finding of tuberculosis among mining communities in Ghana

et al. 2021

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Background Data on active TB case finding activities among artisanal gold mining communities (AMC) is limited. The study assessed the yield of TB cases from the TB screening activities among AMC in Ghana, the factors associated with TB in these communities and the correlation between the screening methods and a diagnosis of TB. Methods We conducted secondary data analyses of NTP program data collected from TB case finding activities using symptom screening and mobile X-ray implemented in hard to reach AMC. Yield of TB cases, number needed to screen (NNS) and the number needed to test (NNT) to detect a TB case were assessed and logistic regression were conducted to assess factors associated with TB. The performance of screening methods chest X-ray and symptoms in the detection of TB cases was also evaluated. Results In total 10,441 people from 78 communities in 24 districts were screened, 55% were female and 60% (6,296) were in the aged 25 to 54 years. Ninety-five TB cases were identified, 910 TB cases per 100,000 population screened; 5.6% of the TB cases were rifampicin resistant. Being male (aOR 5.96, 95% CI 3.25–10.92, P < 0.001), a miner (aOR 2.70, 95% CI 1.47–4.96, P = 0.001) and age group 35 to 54 years (aOR 2.27, 95% CI 1.35–3.84, P = 0.002) were risk factors for TB. NNS and NNT were 110 and 24 respectively.; Cough of any duration had the strongest association with X-ray suggestive of TB with a correlation coefficient of 0.48. Cough was most sensitive for a diagnosis of TB; sensitivity of 86.3% (95% CI 79.4–93.2) followed by X-ray, sensitivity 81.1% (95% CI 71.7–88.4). The specificities of the symptoms and X-rays ranged from 80.2% (cough) to 97.3% (sputum). Conclusion The high risk of TB in the artisanal mining communities and in miners in this study reinforces the need to target these populations with outreach programs particularly in hard to reach areas. The diagnostic value of cough highlights the usefulness of symptom screening in this population that may be harnessed even in the absence of X-ray to identify those suspected to have TB for further evaluation.

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Section: Plos Onesupporting

confidence: 89%

Section: Plos Onementioning

confidence: 64%

Case finding of tuberculosis among mining communities in Ghana

et al. 2021

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“…Male sex, marriage, at least primary education, employment, a good knowledge and practice of TB were predictive of more favourable attitudes to TB. However, the association of male sex with a positive attitude towards TB is unexpected given the Gambian TB prevalence survey [ 3 ] just like others [ 4 , 43 , 44 ] and in concordance with global TB epidemiology shows majority of TB cases are males [ 1 ]. This may be closely related to their health-seeking behaviour when they have TB-like symptoms [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…This disparity between health seeking behaviour and case detection in the community underlies the importance of ensuring health centres are adequately equipped, and health workers are adequately trained to, facilitate early diagnosis and treatment of TB. These will help prevent missed opportunities for TB diagnosis and reduce the spread of TB and possibly associated stigma [ 1 , 18 , 38 , 44 , 45 ]. It is possible that reported health-seeking behaviours might be different from actual actions which may also explain the discordance between a favourable attitude to TB and the preponderance of undiagnosed male TB cases during the TB prevalence survey in Gambia and elsewhere.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey

Bashorun¹,

Linda²,

Omoleke³

et al. 2020

BMC Public Health

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Background Early diagnosis and treatment of tuberculosis (TB) are the mainstay of global and national TB control efforts. However, the gap between expected and reported cases persists for various reasons attributable to the TB services and care-seeking sides of the TB care cascade. Understanding individual and collective perspectives of knowledge, attitudes, beliefs and other social circumstances around TB can inform an evidence-based approach in engaging communities and enhance their participation in TB case detection and treatment. Methods The study was conducted during the Gambian survey of TB prevalence. This was a nationwide cross-sectional multistage cluster survey with 43,100 participants aged ≥15 years in 80 clusters. The study sample, a random selection of 10% of the survey population within each cluster responded to a semi-structured questionnaire administered by trained fieldworkers to assess the knowledge, attitudes and practice of the participants towards TB. Overall knowledge, attitude and practice scores were dichotomised using the computed mean scores and analysed using descriptive, univariable and multivariable logistic regression. Results All targeted participants (4309) were interviewed. Majority were females 2553 (59.2%), married 2614 (60.7%), had some form of education 2457 (57%), and were unemployed 2368 (55%). Although 3617 (83.9%) of the participants had heard about TB, only 2883 (66.9%) were considered to have good knowledge of TB. Overall 3320 (77%) had unfavourable attitudes towards TB, including 1896 (44%) who indicated a preference for staying away from persons with TB rather than helping them. However, 3607(83.7%) appeared to have the appropriate health-seeking behaviours with regard to TB as 4157 (96.5%) of them were willing to go to the health facility if they had symptoms suggestive of TB. Conclusions About 3 in 10 Gambians had poor knowledge on TB, and significant stigma towards TB and persons with TB persists. Interventions to improve TB knowledge and address stigma are required as part of efforts to reduce the burden of undiagnosed TB in the country.

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“…diabetes, smoking) or bovine TB were excluded. Of 162 published papers, only seven were of relevance [18–24]. Grey literature, such as unpublished survey reports produced by national TB programmes, abstracts and presentations from international meetings, and routine progress updates collated by the WHO Global Task Force on TB Impact Measurement on the status of surveys since 2008, was also systematically reviewed [25–36].…”

Section: Methodsmentioning

confidence: 99%

National tuberculosis prevalence surveys in Africa, 2008–2016: an overview of results and lessons learned

Law

Floyd

Abukaraig

et al. 2020

Tropical Med Int Health

125

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Objective and methods Worldwide, tuberculosis (TB) is the leading cause of death from a single infectious agent. In many countries, national TB prevalence surveys are the only way to reliably measure the burden of TB disease and can also provide other evidence to inform national efforts to improve TB detection and treatment. Our objective was to synthesise the results and lessons learned from national surveys completed in Africa between 2008 and 2016, to complement a previous review for Asia. Results Twelve surveys completed in Africa were identified: Ethiopia (2010–2011), Gambia (2011–2013), Ghana (2013), Kenya (2015–2016), Malawi (2013–2014), Nigeria (2012), Rwanda (2012), Sudan (2013–2014), Tanzania (2011–2012), Uganda (2014–2015), Zambia (2013–2014) and Zimbabwe (2014). The eligible population in all surveys was people aged ≥15 years who met residency criteria. In total 588 105 individuals participated, equivalent to 82% (range 57–96%) of those eligible. The prevalence of bacteriologically confirmed pulmonary TB disease in those ≥15 years varied from 119 (95% CI 79–160) per 100 000 population in Rwanda and 638 (95% CI 502–774) per 100 000 population in Zambia. The male:female ratio was 2.0 overall, ranging from 1.2 (Ethiopia) to 4.1 (Uganda). Prevalence per 100 000 population generally increased with age, but the absolute number of cases was usually highest among those aged 35–44 years. Of identified TB cases, 44% (95% CI 40–49) did not report TB symptoms during screening and were only identified as eligible for diagnostic testing due to an abnormal chest X‐ray. The overall ratio of prevalence to case notifications was 2.5 (95% CI 1.8–3.2) and was consistently higher for men than women. Many participants who did report TB symptoms had not sought care; those that had were more likely to seek care in a public health facility. HIV prevalence was systematically lower among prevalent cases than officially notified TB patients with an overall ratio of 0.5 (95% CI 0.3–0.7). The two main study limitations were that none of the surveys included people <15 years, and 5 of 12 surveys did not have data on HIV status. Conclusions National TB prevalence surveys implemented in Africa between 2010 and 2016 have contributed substantial new evidence about the burden of TB disease, its distribution by age and sex, and gaps in TB detection and treatment. Policies and practices to improve access to health services and reduce under‐reporting of detected TB cases are needed, especially among men. All surveys provide a valuable baseline for future assessment of trends in TB disease burden.

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National population-based tuberculosis prevalence survey in Ghana, 2013

Cited by 17 publications

References 0 publications

Case finding of tuberculosis among mining communities in Ghana

Case finding of tuberculosis among mining communities in Ghana

Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey

National tuberculosis prevalence surveys in Africa, 2008–2016: an overview of results and lessons learned

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