Improving tuberculosis case finding among household contacts of tuberculosis patients by using community based model in Addis Ababa, Ethiopia
Year: 2021
Type: dissertation
Study design: Clinical Trial
Abstract: Introduction: World Health Organization recommends screening of household contact \nas a key to improve detection of tuberculosis cases. Ethiopia’s current tuberculosis \nhousehold contact investigation strategies rely on symptomatic contacts attending health \nfacilities for investigation. This approach has not led to the detection of additional \ntuberculosis (TB) cases; alternative approaches have to be considered. The purpose of \nthe research was to develop guidelines in endorsing the implementation of a community \nbased household contact investigation program in Addis Ababa. \nMethods: A mixed method research using sequential exploratory design was conducted \nin Addis Ababa. In the first phase, qualitative data collection and analysis methods were \nused to formulate intervention approach and in the second phase, a quantitative random \ncontrolled trial was conducted, with the purpose of comparing the proposed intervention \nmeasures with routine household contact tuberculosis investigation. Frequencies and \nlogistic regression analyses were used to determine the relative risk and associated \nfactors. Thematic analysis was used for qualitative data analysis. \nResults: The in-depth interview and focus group discussion findings identified themes \nnamely household contact investigation (HHCI) implementation, misconceptions on \nHHCI, challenges with HHCI Approaches, opportunities for HHCI provision, contributing \nfactors associated with household involvement, strategies for effective HHCI service and \npartnerships with health bureau. In phase two, the study reported that the prevalence of \nTB was 7.1% among the intervention group compared to 1.9% in the control groups at \nthe end of first year follow-up. Nine guidelines were developed to support the household \ncontact investigation system. \nConclusion: The passive case detection strategy of contact investigation did not find \nmore cases, and tuberculosis patients and their family contacts were not satisfied with \nthis method. However, the proposed community-based strategy shows that more TB \ncases can be detected by using existing medical staff. Therefore, an approach that makes \nthe service more accessible is significant and the recommended community based TB \nhousehold contact tracing approaches needs to be scaled up for its performance towards \nidentified missed cases and enhance patient and their household contacts involvement.
Author: Zerihun Yaregal Admassu
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Strong, University of South Africa
OpenAlex ID: W7066276101