Evaluation of facility and community-based active household tuberculosis contact investigation in Ethiopia: a cross-sectional study

Details

• Alternative Title:
  BMC Health Serv Res
• Personal Author:
  Tefera, Fana ; Barnabee, Gena ; Sharma, Anjali ; Feleke, Beniam ; Atnafu, Daniel ; Haymanot, Negasi ; O’Malley, Gabrielle ; Feleke, Getachew
• Description:
  Background
  
  No established strategy for household tuberculosis (TB) contact investigation (HTCI) exists in Ethiopia. We implemented integrated, active HTCI model into two hospitals and surrounding community health services to determine yield of active HTCI of all forms of TB and explore factors associated with active TB diagnosis in household contacts (HHCs).
  
  Methods
  
  Case managers obtained HHC information from index cases at TB/DOTS clinic and liaised with health extension workers (HEWs) who screened HHCs for TB at household and referred contacts under five and presumptive cases for diagnostic investigation.
  
  Results
  
  From 363 all forms TB index cases, 1509 (99%) HHCs were screened and 809 (54%) referred, yielding 19 (1.3%) all forms TB cases. HTCI of sputum smear-positive pulmonary TB (SS + PTB) index cases produced yield of 4.3%. HHCs with active TB were more likely to be malnourished (OR: 3.39, 95%CI: 1.19–9.64), live in households with SS + PTB index case (OR: 7.43, 95%CI: 1.64–33.73) or TB history (OR: 4.18, 95%CI: 1.51–11.55).
  
  Conclusion
  
  Active HTCI of all forms of TB cases produced comparable or higher yield than reported elsewhere. HTCI contributes to improved and timely case detection of Tuberculosis among population who may not seek health care due to minimal symptoms or access issues. Active HTCI can successfully be implemented through integrated approach with existing community TB programs for better coordination and efficiency. Referral criteria should include factors significantly associated with active disease.
  
  
• Subjects:
  Adolescent Adult Ambulatory Care Facilities Case Managers Community Health Services Contact Tracing Cross-Sectional Studies Family Health Female Health Personnel Health Workforce Humans Male Occupational Health Program Evaluation Referral And Consultation Tuberculosis Tuberculosis, Pulmonary

  More +
• Source:
  BMC Health Serv Res. 19
• Pubmed ID:
  31010427
• Pubmed Central ID:
  PMC6477729
• Document Type:
  Journal Article
• Funding:
  P30 AI027757/AI/NIAID NIH HHS/United States ; (U91HA06801)/U.S. President's Emergency Plan for AIDS Relief/
• Place as Subject:
  Ethiopia
• Volume:
  19
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a136c93d7d5da4ac6e618d4a8de895372941058e99a76a6c26a3357bff5d87aa
• Download URL:
  https://stacks.cdc.gov/view/cdc/78634/cdc_78634_DS1.pdf
• File Type:
  [PDF - 651.71 KB ]