Reaching the underserved: Active tuberculosis case finding in urban slums in southeastern Nigeria

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

doi:10.1016/j.ijmyco.2014.12.007

Cited by 33 publications

(36 citation statements)

References 17 publications

(20 reference statements)

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“…The regiment comprises of two months of intensive phase using four drugs (Isoniazid, Pyrazinamide, Ethambutol and Rifampicin and four months continuation phase using two drugs, Isoniazid and ethambutol [36] and [47]. The TB control program practices direct observed treatment (DOT) which ensures that patients takes his or her drugs under supervision by the health worker [48].…”

Section: Treatment Of Tuberculosismentioning

confidence: 99%

“…Secondary prevention entails screening, detecting and managing sub-clinical conditions to stop the progression of the disease [3]. This is achieved by early case detection through active case search and prompt treatment [48]. Tertiary prevention tends to reduce the impact of the disease condition by use of chemotherapy and socioeconomic rehabilitation [3].…”

Section: Prevention Of Tuberculosismentioning

confidence: 99%

“…The passive case finding is a proven means of case detection, but it is primarily influenced by poor access, socioeconomic status and might be responsible to low cases notification in Nigeria [22] and [66]. A shift from passive to intensified approach is necessary for improved case notification in Nigeria [48] 2.9.…”

Section: Tb Case Finding In Nigeriamentioning

confidence: 99%

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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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Section: Treatment Of Tuberculosismentioning

confidence: 99%

Section: Prevention Of Tuberculosismentioning

confidence: 99%

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Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

Onuka¹,

Okezie²,

Agboola³

et al. 2018

AID

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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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