Strengthening contact tracing capacity of pulmonary tuberculosis patients in Enugu, southeast Nigeria: a targeted and focused health education intervention study

Abstract

BackgroundNigeria ranks 10 out of the 22 countries in the world with the highest TB burden. Contact tracing enhances case finding and increases the probability of cure. The purpose of the study is to improve the contact tracing skills of tuberculosis patients at the major TB centre in Enugu State, Nigeria.MethodsThe study is an educational intervention with a study and a control groups selected using multi-stage sampling techniques. A calculated sample size of 190 patients was used for each group. The instrument was a pre-tested semi-structured interviewer administered questionnaire. Data entry and analysis was done using Epi-info version 3.3.2. Chi-square test and student t –test were used at p < 0.05 level of significance and 95 percent confidence interval.ResultsAwareness of contact tracing at baseline and post intervention were respectively 18.2% and 85.2% (X2 = 158.4, DF = 1, p = 0.000; CI: 15.8-82.2) for the study group; 18.4% and 26.0% (X2 = 3.31, DF = 1, p = 0.069; CI: -9.9-24.7) for the control group. Knowledge that contact tracing involve bringing all household contacts of TB patients for screening was 79 (44.9%) and 33 (19.2%) for the study and control groups at baseline (X2 = 26.32, p = 0.000; CI: 7.2-44.1), but 151 (85.8%) and 36(20.9%) for the same at post-intervention (X2 = 147.22, p = 0.000; CI: 49.3-80.1). At baseline, only 5 (2.8%) of the study and 6(3.5%) of the control groups ( X2 = 0.12, p = 0.730; CI: -14.2-12.8 ) brought two or more contacts for screening. At post-intervention, the figure rose to 114 (64.8%) and 9 (5.2%) (X2 = 134.94, p = 0.000; CI: 44.3-74.9) for the study and control groups respectively. Over 50% of the contacts brought for screening were less than 10 years; 31 (18.3%) at baseline to 138 (81.7%) post-intervention in the study group (CI: 47.6-79.2), and 26 (35.1%) to 38 (51.4%) for the control group (X2 = 12.472, p = 0.000; CI: 0.1 -32.5).ConclusionIntensive planned health education intervention has been used to improve the contact tracing skills of the TB patients in a major TB centre in Enugu State, Nigeria. Further training and re-training of TB patients on contact tracing is highly recommended.

Disseminated tuberculosis in a Nigerian child: making a case for active contact tracing

“…9 Contact tracing is the process of evaluating persons who have been in contact with patients that have TB. 11 It is invaluable in the TB program, and has been recommended as a strategy to increase TB case finding for many years. 14,15 Contact tracing follows the identification of a tuberculosis index case, and it is an important strategy for the early identification and treatment of childhood tuberculosis, and for the provision of prophylaxis for cases with a high risk of progression of disease.…”

“…13 There are two main types of contact tracing, namely, active contact tracing and passive contract tracing. 11 Active contact tracing involves the regular visits by health workers to the families of patients with TB, while keeping a contact register. 11 In passive contact tracing, there is the health education of the TB patient at the TB clinic, which serves to encourage him or her to bring any family member with suspect symptoms to the health facility for screening.…”

“…11 Active contact tracing involves the regular visits by health workers to the families of patients with TB, while keeping a contact register. 11 In passive contact tracing, there is the health education of the TB patient at the TB clinic, which serves to encourage him or her to bring any family member with suspect symptoms to the health facility for screening. 11 In the index case reported, neither of these types of contact tracing appeared to have been done.…”

“…11 In passive contact tracing, there is the health education of the TB patient at the TB clinic, which serves to encourage him or her to bring any family member with suspect symptoms to the health facility for screening. 11 In the index case reported, neither of these types of contact tracing appeared to have been done. Contact tracing must be strongly advocated for, despite the limited resources in our setting, for it permits the diagnosis of TB in children who are still asymptomatic, as well as helping to identify infected subjects who may benefit from chemoprophylaxis.…”

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

“…More specifically, they found that knowledge, practice and attitude were major impediments to patient contact tracing. In a related interventional health education study on contact tracing by [69] revealed poor knowledge of contact tracing for both the study and control group. According to the study the pre and post intervention results were statistically significant which implies that educating of health workers on contact tracing will improve skills and case notification.…”