Does intensified case finding increase tuberculosis case notification among children in resource-poor settings? A report from Nigeria

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• 作者：Daniel C. Oshi^a ; ^{dannyoshi@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Joseph N. Chukwu^a ; Charles C. Nwafor^a ; Anthony O. Meka^a ; Nelson O. Madichie^a ; Chidubem L. Ogbudebe^a ; Ugochukwu U. Onyeonoro^b ; Joy N. Ikebudu^a ; Ngozi Ekeke^a ; Moses C. Anyim^a ; Kingsley N. Ukwaja^c ; Emmanuel N. Aguwa^d
• 关键词：Childhood tuberculosis ; Intensified case finding ; Nigeria tuberculosis
• 刊名：International Journal of Mycobacteriology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：5
• 期：1
• 页码：44-50
• 全文大小：567 K

文摘

Tuberculosis (TB) is a major cause of morbidity and mortality in developing countries. Passive case detection in national TB programmes is associated with low case notification, especially in children. This study was undertaken to improve detection of childhood TB in resource-poor settings through intensified case-finding strategies.

Methods

A community-based intervention was carried out in six states in Nigeria. The creation of TB awareness was undertaken, and work aids, guidelines, and diagnostic charts were produced, distributed, and used. Various cadres of health workers and ad hoc project staff were trained. Child contacts with TB patients were screened in their homes, and children presenting at various hospital units were screened for TB. Baseline and intervention data were collected for evaluation populations and control populations.

Results

Detection of childhood TB increased in the evaluation population during the intervention, with a mean quarterly increase of 4.0% [new smear positive (NSP), although the increasing trend was not statistically significant (χ² = 1.8; p < .179)]. Additionally, there was a mean quarterly increase of 3% for all forms of TB, although the trend was not statistically significant (χ² = 1.48; p < .224). Conversely, there was a decrease in case notification in the control population, with a mean decline of 3% (all forms). Compared to the baseline, there was an increase of 31% (all forms) and 22% (NSP) in the evaluation population.

Conclusion

Intensified case finding combined with capacity building, provision of work aids/guidelines, and TB health education can improve childhood-TB notification.