A Multi-Faceted Approach to Tuberculosis Active Case Finding among Remote Riverine Communities in Southern Nigeria

Andy Samuel Eyo, Valerie Okon Obot, Okezie Onyedinachi, Nathaly Aguilera Vasquez, Jacob Bigio, Ataulhaq Sanaie, Favour Beulah, Uduak Ette, Dennis Uju and Md. Toufiq Rahman
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Andy Samuel Eyo: Excellence Community Education Welfare Scheme (ECEWS), Uyo 520231, Nigeria
Valerie Okon Obot: Excellence Community Education Welfare Scheme (ECEWS), Uyo 520231, Nigeria
Okezie Onyedinachi: Excellence Community Education Welfare Scheme (ECEWS), Uyo 520231, Nigeria
Nathaly Aguilera Vasquez: McGill International TB Center, Research Institute of the McGill University Health Center, Montreal, QC H3G 1A4, Canada
Jacob Bigio: McGill International TB Center, Research Institute of the McGill University Health Center, Montreal, QC H3G 1A4, Canada
Ataulhaq Sanaie: TB REACH External M&E Reviewer, London E11 4DP, UK
Favour Beulah: Excellence Community Education Welfare Scheme (ECEWS), Uyo 520231, Nigeria
Uduak Ette: Excellence Community Education Welfare Scheme (ECEWS), Uyo 520231, Nigeria
Dennis Uju: Excellence Community Education Welfare Scheme (ECEWS), Uyo 520231, Nigeria
Md. Toufiq Rahman: Stop TB Partnership, 1218 Geneva, Switzerland

IJERPH, 2021, vol. 18, issue 18, 1-11

Abstract: Nigeria accounts for 11% of the worldwide gap between estimated and reported individuals with tuberculosis (TB). Hard-to-reach communities on the Southern Nigeria coast experience many difficulties accessing TB services. We implemented an active case finding (ACF) intervention in Akwa Ibom and Cross River states utilizing three approaches: house-to-house/tent-to-tent screening, community outreach and contact investigation. To evaluate the impact, we compared TB notifications in intervention areas to baseline and control population notifications, as well as to expected notifications based on historical trends. We also gathered field notes from discussions with community volunteers who provided insights on their perspectives of the intervention. A total of 509,768 individuals were screened of which 12,247 (2.4%) had TB symptoms and 11,824 (96.5%) were tested. In total, 1015 (8.6%) of those identified as presumptive had confirmed TB—98.2% initiated treatment. Following implementation, TB notifications in intervention areas increased by 112.9% compared to baseline and increased by 138.3% when compared to expected notifications based on historical trends. In contrast, control population notifications increased by 101% and 49.1%, respectively. Community volunteers indicated a preference for community outreach activities. Multi-faceted, community-based interventions in Nigeria’s coastal areas successfully increase TB detection for communities with poor access to health services.

Keywords: tuberculosis; active case finding; community-based (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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