TITLE:
Assessment of Contributions of Community Tuberculosis Intervention to Tuberculosis Case Detection and Treatment Outcome in Two States in Nigeria
AUTHORS:
Audu Onyemocho, Hassan Abiodun, Queen Ogbuji, Adewale Osho, Shember-Agela Igbabul, Gajere Julius, Omole Victoria Nanben, Anejo-Okopi Joseph
KEYWORDS:
Case Detection, Community Care, Contribution, Tuberculosis, Treatment Outcome
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.8 No.3,
August
17,
2020
ABSTRACT: Background: Nigeria, one of the high burden
Tuberculosis countries, has developed various intervention strategies to ensuring
universal access to quality-assured tuberculosis diagnosis and treatment.
However, low case detection and
unsuccessful treatment outcome still remains a serious challenge in most
states. Community Tuberculosis care was born against this background in 2010 as
a complementing front to combat the challenges, bringing directly observed treatment short-course strategy beyond
the clinic settings to the door steps of patients. This study evaluates the
contributions of the intervention to Tuberculosis case detection and treatment
outcomes in two states in Nigeria. Materials and Method: A retrospective
study with multistage sampling technique was employed to review 23,241 presumptive Tuberculosis cases
enrolled for management between 2014-2017. Chi-square (χ2) test was used for test of association between the
independent variables and the main outcomes of the study, with statistical significance set at p-value of 5%. Results:
The annual percentage increase for both states was 24.7%, 189.8% and 114.5% in the study group as against 5.2%, 44.6% and 65.6% in control group.
Overall, 23.8% were bacteriologically
positive (either AFB or Gene-Xpert MTB/Rif) and 1.4% were clinically evaluated
to be positive, while 74.8% were
bacteriologically negative. Of the total 5861 cases treated, successful treatment rate of the patients in the study group was
88.6% as compared to 76.1% in the control group. The relationship between the
referral system from communities where the intervention program was implemented
and the case detection/treatment outcome was statistically significant (OR 95%
CI = 3.15, 2.95 - 3.35). Conclusion: The community level
Tuberculosis intervention led to significantly better case detection and
treatment outcome when compared to the conventional approach (p ≤ 0.05).
Therefore, full community engagement
should be advocated as a major strategy for End Tuberculosis planed by WHO
since the patients are found in the community and not in the health facilities.