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Research article
Tabitha Abongo
Amref Health Africa in Kenya
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3857-1493
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Contact investigation is important in finding contacts of people who have Tuberculosis (TB) disease so that they can be given treatment and stop further transmission. The main objective of this study was to assess the contribution of community health volunteers (CHVs) to the number of TB patients notified to the National program in Kenya through household contact screening and referral of persons with TB signs and symptoms to the facilities for further investigation.
Methods: This was a retrospective desk review of project reports submitted to Amref Health Africa in Kenya by the sub recipients implementing activities in the 33 counties with Case Notification Rate (CNR) of less 175/100,000 and Treatment Success Rate (TRS) of less than 88% as per the National strategic plan 2015-2018. Data for this study covered a time period between January and December 2016. Data on the notified TB patients was obtained from the National Tuberculosis Information Basic Unit (TIBU). The study population included all the TB index cases whose households were visited by CHVs for contact screening. Data was recorded into excel spreadsheets where descriptive analysis was done, proportions calculated and summarized in a table.
Results: Community health volunteers visited a total of 26,307 TB patients (index cases) in their households for contact screening. A total of 44,617 household members were screened for TB with 43,012 (96.40%) coming from households of bacteriologically confirmed TB patients and 1,606 (3.60%) from households of children under 5 years. The proportion of the persons referred in relation to the number screened was 19.6 % for those over 5 years and 21.9 % from under 5 years with almost the same percentages for male and female at 19.2% and 19.7 % respectively. The percentage of (TB) cases identified through tracing of contacts in these counties improved to 10% (5,456) of the 54,913 cases notified to the National TB Program while the percentage of notified TB cases, all forms contributed though community referrals improved to 6 % (3,365)
Conclusions: This study showed that in the 33 counties of Global Fund TB project implementation the percentage of TB cases identified through tracing of contacts improved from 6% to 10% while the percentage of notified TB cases; all forms contributed through community referrals improved from 4% to 8%. Community health volunteers can play an effective role in household contact screening and referrals for identification of TB.
Keywords
Contact screening, Tuberculosis, Contact tracing, Community Health Volunteers, Community Health Workers
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View the published article at BMC Public Health.
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Posted 15 May, 2020
No community comments so far
Reviewers invited
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Reviewer #1 agreed
On 01 May, 2020
Reviewer #2 agreed
On 01 May, 2020
Editor assigned
On 30 Apr, 2020
Editor invited
On 29 Apr, 2020
Submission checks complete
On 14 Jan, 2020
No comments provided
Editorial decision: Major revision
On 01 Apr, 2020
Editor assigned
On 24 Mar, 2020
Submission checks complete
On 23 Mar, 2020
Editor invited
On 23 Mar, 2020
Community comments: 1
Editorial decision: Minor revision
On 08 Mar, 2020
Review #3 received
Received 26 Feb, 2020
Reviewer #3 agreed
On 19 Feb, 2020
Review #2 received
Received 16 Feb, 2020
Review #1 received
Received 13 Feb, 2020
Reviewer #2 agreed
On 03 Feb, 2020
Editor assigned
On 16 Jan, 2020
Reviewers invited
Invitations sent on 16 Jan, 2020
Reviewer #1 agreed
On 16 Jan, 2020
Submission checks complete
On 15 Jan, 2020
Editor invited
On 15 Jan, 2020
First submitted
On 07 Jan, 2020
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Subject Areas
Health Policy
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tabitha Abongo
Amref Health Africa in Kenya
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3857-1493
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 3
Posted 15 May, 2020
No community comments so far
Reviewers invited
Invitations sent on 01 May, 2020
Reviewer #1 agreed
On 01 May, 2020
Reviewer #2 agreed
On 01 May, 2020
Editor assigned
On 30 Apr, 2020
Editor invited
On 29 Apr, 2020
Submission checks complete
On 14 Jan, 2020
No comments provided
Editorial decision: Major revision
On 01 Apr, 2020
Editor assigned
On 24 Mar, 2020
Submission checks complete
On 23 Mar, 2020
Editor invited
On 23 Mar, 2020
Community comments: 1
Editorial decision: Minor revision
On 08 Mar, 2020
Review #3 received
Received 26 Feb, 2020
Reviewer #3 agreed
On 19 Feb, 2020
Review #2 received
Received 16 Feb, 2020
Review #1 received
Received 13 Feb, 2020
Reviewer #2 agreed
On 03 Feb, 2020
Editor assigned
On 16 Jan, 2020
Reviewers invited
Invitations sent on 16 Jan, 2020
Reviewer #1 agreed
On 16 Jan, 2020
Submission checks complete
On 15 Jan, 2020
Editor invited
On 15 Jan, 2020
First submitted
On 07 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: Contact investigation is important in finding contacts of people who have Tuberculosis (TB) disease so that they can be given treatment and stop further transmission. The main objective of this study was to assess the contribution of community health volunteers (CHVs) to the number of TB patients notified to the National program in Kenya through household contact screening and referral of persons with TB signs and symptoms to the facilities for further investigation.
Methods: This was a retrospective desk review of project reports submitted to Amref Health Africa in Kenya by the sub recipients implementing activities in the 33 counties with Case Notification Rate (CNR) of less 175/100,000 and Treatment Success Rate (TRS) of less than 88% as per the National strategic plan 2015-2018. Data for this study covered a time period between January and December 2016. Data on the notified TB patients was obtained from the National Tuberculosis Information Basic Unit (TIBU). The study population included all the TB index cases whose households were visited by CHVs for contact screening. Data was recorded into excel spreadsheets where descriptive analysis was done, proportions calculated and summarized in a table.
Results: Community health volunteers visited a total of 26,307 TB patients (index cases) in their households for contact screening. A total of 44,617 household members were screened for TB with 43,012 (96.40%) coming from households of bacteriologically confirmed TB patients and 1,606 (3.60%) from households of children under 5 years. The proportion of the persons referred in relation to the number screened was 19.6 % for those over 5 years and 21.9 % from under 5 years with almost the same percentages for male and female at 19.2% and 19.7 % respectively. The percentage of (TB) cases identified through tracing of contacts in these counties improved to 10% (5,456) of the 54,913 cases notified to the National TB Program while the percentage of notified TB cases, all forms contributed though community referrals improved to 6 % (3,365)
Conclusions: This study showed that in the 33 counties of Global Fund TB project implementation the percentage of TB cases identified through tracing of contacts improved from 6% to 10% while the percentage of notified TB cases; all forms contributed through community referrals improved from 4% to 8%. Community health volunteers can play an effective role in household contact screening and referrals for identification of TB.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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