Population-based Screening for Pulmonary Tuberculosis utilizing Community Health Workers in Ethiopia

Merid, Yared, Mulate, Yimtubezinash Woldeamanuel, Hailu, Mesay, Hailu, Tsegaye, Habtamu, Getnet, Abebe, Markos, Datiko, Daniel and Aseffa, Abraham (2019) 'Population-based Screening for Pulmonary Tuberculosis utilizing Community Health Workers in Ethiopia'. International Journal of Infectious Diseases, Vol 89, pp. 122-127.

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Abstract

Objective
To evaluate the utility of a volunteer health development army in conducting population screening for active TB in a rural community in Southern Ethiopia.

Methods
A population-based cross-sectional survey was conducted in sixKebeles (the lowest administrative units).Volunteer women community workers led a symptom screening program to identify adults ≥15 years with TB in the community. Individuals with cough ≥ 2 weeks had spot and morning sputum samples and were examined using AFB smear microscopy, culture and Xpert MTB/RIF.

Results
All 24,517 adults in the study area had a symptom screen performed; 544 (2.2%) had cough ≥ 2 weeks. Among a positive symptom screen, 13 (2.4%) had a positive sputum AFB smear microscopy, 13 (2.4%) a positive culture and 32 (5.8%) a positive Xpert MTB/RIF test. Overall, 34 TB cases (6%) were identified by culture and/or Xpert which corresponds to a prevalence of 139 per 100,000 persons.

Conclusion
We demonstrate the capability of community health workers (volunteer and paid) to rapidly conduct a large-scale population TB screening evaluation and highlight the high yield of such a program to detect previously undiagnosed cases when combined with Xpert MTB/RIF testing. This could be a model to implement in other similar settings.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General) WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis WF Respiratory System > Tuberculosis > WF 300 Pulmonary tuberculosis
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.ijid.2019.10.012
Depositing User:	Stacy Murtagh
Date Deposited:	28 Oct 2019 15:48
Last Modified:	20 Nov 2019 15:23
URI:	https://archive.lstmed.ac.uk/id/eprint/12918

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