Population-Based Tuberculosis Disease Prevalence Survey in Ghana: The Role and Lessons Learnt from the Laboratory (original) (raw)
Related papers
National population-based tuberculosis prevalence survey in Ghana, 2013
The International Journal of Tuberculosis and Lung Disease, 2020
BACKGROUND: The prevalence of tuberculosis (TB) disease is one of the three main indicators used to assess the epidemiological burden of TB and the impact change of TB control; the other two are incidence and mortality.OBJECTIVE: To estimate the prevalence of TB disease among adults in Ghana.METHODS: A nationally representative cross-sectional survey was conducted. Participants were screened for TB using interview and chest X-ray (CXR). For those participants with cough ≥2 weeks and/or abnormal CXR, spot and morning sputum specimens were collected and examined by smear microscopy and culture.RESULTS: The study revealed that the prevalence of smear-positive TB among adults (age ≥15 years) was 111 (95%CI 76–145) and that of bacteriologically confirmed TB was 356 (95%CI 288–425) per 100 000 population. Males and older people had a higher prevalence than their counterparts. The majority of TB cases were smear-negative and had an abnormal CXR without reported chronic cough.CONCLUSION: Th...
The study had two main broad but related objectives. The first objective was to determine the actual causes of under detection of pulmonary TB cases in the Northern Region of Ghana. Data was collected through administering a structured questionnaire; and collection of sputum samples from the respondents. The second objective was to determine the actual causes of low smear positive rates by assessing the capacity to effectively perform sputum smear microscopy for Acid Fast Bacilli (AFBs) in the district hospitals where the study was conducted. Collection of data here involved the use of a structured checklist for the laboratory and the staff who performed Tb microscopy. In all, 26 laboratory staff who performed Tb microscopy in the study district hospital laboratories were involved. The study lasted for a period of three months. The study revealed that, 41.2% of the study participants did not go to hospital when they fell sick. Out of this figure, 20.4% (21) attributed their inability to do so to poverty, 4.9% (5) to lack of access, 35.9% (37) to stigma, 28.2% (29) to cultural beliefs and 10.6%(11) attributed it to other reasons.
TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH, 2016
Background: With an estimated 9.4 million new cases globally, tuberculosis (TB) continues to be a major public health concern 1. Eighty percent of all cases worldwide occur in 22 high-burdens, mainly resource-poor settings. This devastating impact of tuberculosis on vulnerable populations is also driven by its deadly synergy with HIV. Therefore, building capacity and enhancing universal access to rapid and accurate laboratory diagnostics are necessary to control TB and HIV-TB co-infections in resource-limited countries 2. In low income countries (Nigeria inclusive), Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment 3. There is dearth of data on the prevalence of pulmonary tuberculosis (PTB) among patient attendees from individual Institutions and Health Care Facilities performing sputum smear microscopy in Nigeria. This retrospective study will analyze sputum smear microscopy results among pulmonary TB suspected patients presenting to National Hospital Abuja, Federal Capital Territory (FCT), Nigeria. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2010 to December 2014 were retrieved from the TB Laboratory Register of the Medical Microbiology department and analyzed. Methods: This hospital based retrospective study analyzed sputum smear microscopy results among pulmonary TB suspected patients presenting to the National Hospital Abuja, Federal Capital Territory, Nigeria. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2010 to December 2013 were retrieved from the TB Laboratory Register of the Medical Microbiology department and analyzed. Data processing and statistical analysis were performed using SPSS software (Windows version 16.0). The results were expressed as percentage, with significance at 5%. Results: The overall prevalence of sputum smear positive cases were 17.3% (63 0f 364) and most of the positive patients were within the age range 15-44 years. The highest percentage of TB was seen in the age group of 15-24 years compared with the lowest percentages in the age group below 14 years and above 45 years. A total of 63 (17.3%) suspects were found to have at least one positive. Of these, 56 (88.9% of those with one or more positive smears and 92% of those who fulfilled the case definition) were detected from the first specimen and 7 (11.1%) were positive on the second specimen but not the first. The third specimen did not have any additional diagnostic value for the detection of AFB. Conclusion: The prevalence of sputum smear positive cases of 18.3% increases with age up to the age 44 years. Our result show that examining two sputa smears was sufficient for the detection of AFB in our laboratory. Further research involving different laboratories from all of the six geo-political groups in Nigeria is needed to reassess these findings.
Population-based prevalence survey of tuberculosis in the Tigray region of Ethiopia
BMC Infectious Diseases, 2013
Background: Population based prevalence survey is an important epidemiological index to measure the burden of tuberculosis (TB) disease and monitor progress towards TB control in high burden countries like Ethiopia. This study was aimed to estimate the prevalence of bacteriologically confirmed pulmonary tuberculosis (PTB) in the Tigray region of Ethiopia. Methods: Sixteen rural and urban villages were randomly selected in a stratified multistage cluster sampling. Individuals aged 15 years and older were screened by symptom inquiry for PTB. Those individuals who were symptomatic of PTB provided two sputum samples for smear microscopy, culture and molecular typing.
The prevalence of tuberculosis infection using tuberculin skin test (TST)-Mantoux test was obtained in 450 children of adolescent age attending secondary school in Zaria. Annual Risk of infection for the children surveyed was calculated using formula ARTI = 1-(1-p) 1/n. The prevalence of positivity was calculated using two cut off values.The prevalence of tuberculin positivity obtained was 43.3% using Mantoux reading of >10mm as positivity. The overall ARTI for the study population was thus 9.2%. The distribution of Mantuox results by sex. Total number of subjects with positive Mantoux is 19.5, giving a prevalence rate of 43.3%. The prevalence rate for boys was 41.2%, while that of girls was 53.2%. This was statistically significant z-statistic = 2.0 (p > 0.05). The Mantoux value was 7.79 +-5,37mm.Thirty percent (30%) had borderline positivity while 2.9% was satisfactory negative including 23.8% that had no induration at all. Fourty-three (43) subjects, representing 9,5% had a strongly positive result >/ 15mm. In this study, the ARTI was 9.2% and 6.4% corresponding to annual incidence of 460 and 320 new cases of smear positive TB respectively.In the absence of good TB control programme and proper record keeping as seen in most resource poor countries, Nigeria inclusive, the ARTI could be invaluable in the assessment and evaluation of TB activities including formulation of national policies. INTRODUCTION The advent of HIV/AIDS pandemic has worsened the tuberculosis (TB) situation in developing countries including Nigeria (Chretien, 1990). Diagnosis is difficult especially in children due to lack of sensitive laboratory tests and the clinical features that are similar to many other childhood illnesses. Annual risk of tuberculosis infection (ARTI) is an important index of following the trend of the TB situation in a given community (Borgdoff, 2002). The ARTI expresses the annual incidence of infection, and represents the percentage of individuals first infected in the course of one year. This is calculated from a measured prevalence of infection and the mean age of the cohort of children at the time of the survey using a mathematical model (Sutherland et al., 1971). The ARTI is independent of the quality and comprehensiveness of the notification system and has a very close relationship with the number of sources of infection present within the population at large (Styblo et al.,1969).
Ghana Medical Journal
Objective: To assess the progress made towards the actualization of the 80% reduction in incident cases, monitor trends and to assess the quality of GWM TB surveillance data from 2012 to 2016.Design: The study was descriptive secondary data analysisData Source: Tuberculosis cases recorded in the District Health Information Management Systems (DHIMS) and municipal TB registers. The Municipal TB Coordinator was interviewed for clarification on the data. A TB patient was defined as one who coughed persistently for two weeks or more.Main outcome measure: Trend of TB cases in Ga West MunicipalityResults: A total of 441 TB cases were registered of which 68.9% were smear positive. Males were (67%). Age group 35-44 years were the most affected (28.6%). The incidence rose from 21.5 (2012) to 41.6 (2015). The 2016 incidence was 40.7 (± 5.63) per 100,000 population. This is significantly different from the current national incidence of 156 (p < 0.05). Data was 95% complete. Discrepancies ex...