Implementation status of household contact tuberculosis screening by health extension workers: assessment findings from programme implementation in Tigray region, northern Ethiopia

Gebretnsae, Hailay; Ayele, Brhane; Hadgu, Tsegay; Haregot, Esayas; Gebremedhin, Aregay; Michael, Eyassu; Abraha, Mebrahtu; Datiko, Daniel Gemechu; D, Jerene

doi:10.1186/s12913-020-4928-x

Cited by 7 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This could be due to the active involvement of community members mainly WDA leaders in presumptive TB identification. This finding is supported by the previous studies done in Ethiopia which revealed that HEWs who discussed TB issues through regular meeting with WDA leaders had a role in improving TB screening practice [19]. In Ethiopia, the WDA leaders are primary contact with communities and they are expected to search for people with symptoms of TB in their team by asking whether anyone in the households have had a cough for two weeks or more and then they inform to HEWs immediately if there are symptomatic TB individuals [13].…”

Section: Plos Onesupporting

confidence: 83%

“…Furthermore, WDAs supports HEWs in liaising them with community members. HEWs have been conducting regular meetings with the WDA leaders, exchanging feedback on their work and receiving reports of activities performed by the WDA leaders [ 19 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…In Ethiopia, the presence of HEWs in the community could increase access to TB diagnostic and treatment services [14,15], and ACF intervention through HEWs in the community could improve the TB case detection rate [16][17][18]. However, the routine household contacts screening and TB cases notification by HEWs remains low [19,20].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Health extension workers contribution on tuberculosis case notification in Tigray region, Northern Ethiopia: A concurrent mixed method study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Despite the emphasis placed on Community Based Tuberculosis Care (CBTC) implementation by Health Extension Workers (HEWs) within the National Tuberculosis Program (NTP) in Ethiopia, there is little evidence on contribution of HEWs on TB case notification. Therefore, this study aimed to describe the contribution of HEWs on TB case notification and its associated factors in Tigray region, Northern Ethiopia. Methods A concurrent mixed method (quantitative and qualitative) cross-sectional study design was conducted in three randomly selected districts in Tigray region, Northern Ethiopia. Quantitative data were collected using a pre-tested semi-structured questionnaire. Qualitative data were collected using Focused Group Discussions (FGDs) and Key Informant Interviews (KIIs) to further describe the community participation and presumptive TB identification and referral system. For the quantitative data, binary logistic regression analysis was done and all variables with P-value of < 0.25 in bivariate analysis were included in the multi-variable model to see predictors of HEWs contribution to TB notification. The qualitative data were thematically analyzed using Atlas.ti version 7. Results In this study, a total of 68 HEWs were included. From March 1, 2017 to February 28, 2018, a total of 427 TB cases notified in the study areas and one-third (34%) of them were notified by the HEWs referral. Provision of Community Based-Directly Observed Treatment Short course (CB–DOTS) (Adjusted Odds Ratio (AOR) = 3.63, 95% Confidence Interval (CI) = 1.18–11.19) and involvement of community volunteers on CBTC (AOR = 3.31, 95% CI = 1.10–10.09) were significantly associated with the contribution of HEWs on TB case notification. The qualitative findings indicated that high workload of HEWs, inaccessibility of TB diagnostic services at nearby health facilities, and transportation and investigation costs were identified as factors affecting for presumptive TB referral by HEWs. Conclusions Provision of CB-DOTS and involvement of community volunteers in CBTC activities should be strengthened to improve the HEWs contribution on TB case notification. Additionally, HEWs should be empowered and further interventions of TB diagnostic services at diagnostic health facilities are needed to improve presumptive TB referral by HEWs.

show abstract

Section: Plos Onesupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Health extension workers contribution on tuberculosis case notification in Tigray region, Northern Ethiopia: A concurrent mixed method study

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, another study in Tigray reported a low level of knowledge about the cause of TB and the consequences of a poor treatment adherence to its treatment [ 69 ]. Besides, a recent assessment report in Tigray Region indicates that only 21.7% of household contacts were screened for TB by health extension workers [ 70 ], which are by far lower than the target stated by the national TB program to screen all household contacts [ 71 ] and WHO target of greater than 90% household contacts to be screened for TB [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of pulmonary multidrug-resistant tuberculosis patients in Tigray Region, Ethiopia: A cross-sectional study

et al. 2020

View full text Add to dashboard Cite

Background Tuberculosis (TB) is among the top 10 causes of mortality and the first killer among infectious diseases worldwide. One of the factors fuelling the TB epidemic is the global rise of multidrug resistant TB (MDR-TB). The aim of this study was to determine the magnitude and factors associated with MDR-TB in the Tigray Region, Ethiopia. Method This study employed a facility-based cross-sectional study design, which was conducted between July 2018 and August 2019. The inclusion criteria for the study participants were GeneXpert-positive who were not under treatment for TB, PTB patients’ ≥15 years of age and who provided written informed consent. A total of 300 participants were enrolled in the study, with a structured questionnaire used to collect data on clinical, sociodemographic and behavioral factors. Sputum samples were collected and processed for acid-fast bacilli staining, culture and drug susceptibility testing. Drug susceptibility testing was performed using a line probe assay. Logistic regression was used to analyze associations between outcome and predictor variables. Results The overall proportion of MDR-TB was 16.7% (11.6% and 32.7% for new and previously treated patients, respectively). Of the total MDR-TB isolates, 5.3% were pre-XDR-TB. The proportion of MDR-TB/HIV co-infection was 21.1%. A previous history of TB treatment AOR 3.75; 95% CI (0.7–2.24), cigarette smoking AOR 6.09; CI (1.65–2.50) and patients who had an intermittent fever (AOR = 2.54, 95% CI = 1.21–5.4) were strongly associated with MDR-TB development. Conclusions The magnitude of MDR-TB observed among new and previously treated patients is very alarming, which calls for an urgent need for intervention. The high proportion of MDR-TB among newly diagnosed cases indicates ongoing transmission, which suggests the need for enhanced TB control program performance to interrupt transmission. The increased proportion of MDR-TB among previously treated cases indicates a need for better patient management to prevent the evolution of drug resistance. Assessing the TB control program performance gaps and an optimal implementation of the WHO recommended priority actions for the management of drug-resistant TB, is imperative to help reduce the current high MDR-TB burden in the study region.

show abstract

“…Health education regarding TB by health care workers is a factor that improves screening adherence of household contact by 2.6 times (Shiferaw et al, 2019). Other studies revealed that health education by health extension workers to household contact was an important factor in improving their participation in TB screening by 4.2 times (Gebretnsae et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

The Implementation of Comprehensive Health Education to Improve Household Contacts’ Participation in Early Detection of Tuberculosis

Putra

Dewi²,

Probandari

et al. 2021

Health Educ Behav

View full text Add to dashboard Cite

Lack of participation of household contacts is the main problem of early detection of tuberculosis (TB) in Indonesia. A comprehensive health education (CHE) program has been developed to encourage the participation of household contacts. This study aimed to assess the implementation of the CHE to improve participation of household contacts in early detection of TB. This was a quasi-experimental study conducted between November 2018 and June 2019 in Badung District, Bali, Indonesia. Twelve public health centers (PHCs) were randomly allocated to six PHCs implementing the CHE and six PHCs implementing standard health education (SHE). The CHE was developed through a pilot study using the health belief model supplemented with perceived stigma and social support to identify the factors that influence participation. The participation was measured using a TB register with a cross-check to the health care officer until 2 months after health education was provided. Four hundred and twenty-eight household contacts enrolled in this study—216 in the CHE group and 212 in the SHE group. The CHE group’s participation was 28.2%, with 10 new TB cases found; in the SHE group, the participation was 15.6%, with 3 new TB cases found. The CHE increased the household contact participation by 1.83-fold (95% confidence interval [1.19, 2.81]) and case findings by 3.13-fold (95% confidence interval [0.85, 11.56]). The CHE implementation should be scaled up to other areas with a high level of TB transmission. The content and technique of the CHE could also be incorporated in contact investigation guidelines and materials for the TB campaign.

show abstract

Implementation status of household contact tuberculosis screening by health extension workers: assessment findings from programme implementation in Tigray region, northern Ethiopia

Cited by 7 publications

References 32 publications

Health extension workers contribution on tuberculosis case notification in Tigray region, Northern Ethiopia: A concurrent mixed method study

Health extension workers contribution on tuberculosis case notification in Tigray region, Northern Ethiopia: A concurrent mixed method study

Characteristics of pulmonary multidrug-resistant tuberculosis patients in Tigray Region, Ethiopia: A cross-sectional study

The Implementation of Comprehensive Health Education to Improve Household Contacts’ Participation in Early Detection of Tuberculosis

Contact Info

Product

Resources

About