Assessment of Family Tuberculosis Contact Screening Practice and its Associated Factors Among Pulmonary Tuberculosis Positive Patients in South Wollo Zone, Amhara Region, Ethiopia (original) (raw)
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2019
Background: Contacts of patients with tuberculosis have a substantial risk of developing the disease. Household contact screening has recently been recommended as a strategy to enhance case detection in high-burden countries but there is no enough information in Gondar Town regarding household contact screening practice among TB patients. Objective: The aim of this study was to assess the magnitude of household contact screening adherence and associated factors among adult tuberculosis patients attending at health facilities in Gondar Town, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March 1 to 30, 2019 on 404 tuberculosis patients attending at health facilities in Gondar Town. Epi-Info version 7 for data entry and SPSS version 20 for data analysis were used. Descriptive statistics were carried out to illustrate the means, standard deviations, and frequencies of study variables. Bivariable and multivariable logistic regression analyses ...
PLOS ONE, 2020
Background Aligned with global childhood tuberculosis (TB) road map, Ethiopia developed its own in 2015. The key strategies outlined in the Ethiopian roadmap are incorporating TB screening in Integrated Maternal, Neonatal and Child Illnesses (IMNCI) clinic for children under five years (U5) and intensifying contact investigations at TB clinic. However, these strategies have never been evaluated. Objective To evaluate the integration of tuberculosis (TB) screening and contact investigation into Integrated Maternal, Neonatal and Child Illnesses (IMNCI) and TB clinics in Addis Ababa, Ethiopia. Methods The study used mixed methods with stepped-wedge design where 30 randomly selected health care facilities were randomized into three groups of 10 during August 2016-November 2017. The integration of TB screening into IMNCI clinic and contact investigation in TB clinic were introduced by a three-day childhood TB training for health providers. An in-depth interview was used to explore the challenges of the interventions and supplemented data on TB screening and contact investigation. Results Overall, 180896 children attended 30 IMNCI clinics and145444 (80.4%) were screened for TB. A total of 688 (0.4%) children had presumptive TB and 47(0.03%) had TB. During the
BMC Health Services Research
Background In the Tigray region of Ethiopia, Health Extension Workers (HEWs) conduct Tuberculosis (TB) screening for all household (HH) contacts. However, there is limited evidence on implementation status of HH contact TB screening by HEWs. The aim of this program assessment was to describe the implementation status and associated factors of HH contact TB screening by HEWs. Methods This programme assessment was conducted in three randomly selected districts from March to April 2018. Data was collected by using pre-tested structured questionnaire. Descriptive statistics was carried out using frequency tables. Logistic regression analysis was done to identify factors associated with HH contacts screening by HEWs. Results In this programme assessment a total of HHs of 411 index TB cases were included. One-fifth (21.7%) of index TB cases had at least one HH contact screened for TB by HEWs. Having TB treatment supporter (TTS) during intensive phase of index TB case (AOR = 2.55, 95% CI: ...
Tuberculosis Research and Treatment
Background. Children are highly susceptible to Mycobacterium tuberculosis infection, and about 70% of children living in the same households with pulmonary tuberculosis-positive patients will become infected. However, pulmonary positive tuberculosis is a common phenomenon and the implementation of the recommended contact screening and initiation of isoniazid preventive therapy is very low. Therefore, this study is aimed at assessing contact screening practice and initiation of isoniazid preventive therapy of under-five children among pulmonary tuberculosis-positive patients in Bahir Dar, northwest Ethiopia. Methods. A facility-based cross-sectional study was conducted from March 1 to 30, 2016. A total of 267 pulmonary tuberculosis-positive patients were included in this study. To identify independent predictors of contact screening and isoniazid preventive therapy initiation, we performed multivariable logistic regression analyses using SPSS version 20 with CI of 95% at p value <...
BMC Health Services Research, 2019
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 (
PLOS ONE, 2016
Objective To determine the yield and determinants of retrospective TB contact investigation in selected zones in Ethiopia. Materials and Methods This was a community-based cross-sectional study conducted during June-October 2014. Trained lay providers performed symptom screening for close contacts of index cases with all types of TB registered for anti-TB treatment within the last three years. We used logistic regression to determine factors associated with TB diagnosis among the contacts. Results Of 272,441 close contacts of 47, 021 index cases screened, 13,886 and 2, 091 had presumptive and active TB respectively. The yield of active TB was thus 768/100, 000, contributing 25.4% of the 7,954 TB cases reported from the study zones over the study period. The yield was highest among workplace contacts (12,650/100, 000). Active TB was twice more likely among contacts whose index cases had been registered for TB treatment within the last 12 months compared with those who had been registered 24 or more months earlier (adjusted odds ratio, AOR: 1.77 95% CI 1.42-2.21). Sex or clinical type of TB in index cases was not associated with the yield. Smear negative (SS-) index cases (AOR: 1.74 955 CI 1.13-2.68), having index cases who registered for treatment within <12 months (AOR:
ABSTRACTObjectiveIn Ethiopia, a third of the estimated tuberculosis cases are not detected or reported. Incidence estimates are inaccurate and are rarely measured directly. Any tuberculosis program will miss some tuberculosis cases and assessing the ‘‘real’’ incidence under program conditions is useful to understand the situation. This study aimed to measure the prevalence and incidence of pulmonary tuberculosis based on three rounds of household visits in the adult population of Dale in Ethiopia.DesignA prospective population-based cohort study.SettingEvery household in Dale district was visited three times at 4-month interval over 12 months.ParticipantsIndividuals aged 15 and more years were followed.Outcome measuresMicroscopy smear-positive PTB (PTB s+), bacteriologically confirmed PTB (PTB b+) by microscopy, GeneXpert, or culture, and clinically diagnosed PTB (PTB c+).ResultsAmong 136,181 individuals, 2052 had presumptive TB in round1, including 93 with PTB s+, 98 with PTB b+, a...
Tuberculosis Research and Treatment
Background. Tuberculosis is an infectious airborne disease caused by Mycobacterium tuberculosis. It still remains a major public health problem which affects all age groups. Risk of exposure is higher in household contact than members of the general population. Objective. The aim of this study was to assess the prevalence and associated factors of tuberculosis among adult household contacts of smear positive pulmonary tuberculosis in Haramaya district, Oromia Region, Eastern Ethiopia from February to March, 2019. Method. A community based cross-sectional study design was conducted. A total of 454 study participants were selected using systematic sampling method from all adult household contacts of smear positive pulmonary tuberculosis patients treated from July 2017 to December 2018. Data were collected using a pretested and structured questionnaire; and laboratory examination was processed using fluorescent smear microscope. Logistic regression analysis was used to identify the fac...
BMC Public Health
Background: Household Contacts (HHCs) of patients with pulmonary tuberculosis (PTB) have a higher risk of developing TB. Contact investigation is recommended to reach this group and identify undiagnosed cases. In this study, we have determined the yield of contact investigation among HHCs of patients with smear-positive PTB, and estimated TB burden. Methods: We conducted retrospective record review for the occurrence of TB among HHCs of Index PTB+ cases treated between November 2010 and April 2013 in 12 public health facilities in Boricha district. HHCs were followed up monthly and revisited between March and June 2015. Information on additional TB cases diagnosed and treated among HHCs were documented. HHCs who were diagnosed as having TB after the index cases were diagnosed and treated were considered as 'incident cases'. Presumptive TB case was defined as those having cough for ≥2 weeks or enlarged lymph node. Diagnosis of TB among HHCs were made using smear-microscopy and/or X-rays, and clinically for Extra-pulmonary TB (EPTB). Results: One thousand five hundred and seventeenth HHCs of 344 index cases were visited and screened for TB and followed up for a median of 37 months. 77 (5.1%-72 with PTB and 5 with EPTB) HHCs developed TB during 4713 person-years of follow-up with an estimated incidence of 1634 (95% CI: 1370-2043) per 100,000 person-years follow-up which is much higher than the estimated TB incidence for the general population in Ethiopia of 210/100, 000. Half (41/77) of incident TB cases were diagnosed within the first year of diagnosis of the index cases and 88% (68/77) were adults (Hazard Ratio: 4.03; 95% CI: 2.00-8.12). Conclusion: HHCs of index PTB+ cases have high risk of developing active TB. Long term follow-up of HHCs could help improve TB case finding depending on country contexts. Further studies on effectiveness and feasibility of the approach and integration in routine settings are needed.