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Community care workers boost TB case finding among hard-to-reach adults
Lesley Odendal, 2015-12-23 09:00:00
Community care worker active case finding is an effective tool for increasing TB case detection, according to two studies presented at the 46th Union World Conference on Lung Health held in Cape Town from 2 to 6 December. Finding and diagnosing TB is the essential first step to closing the global gap in diagnosing TB.
Screening for signs and symptoms of HIV, TB and diabetes by volunteer community care workers at household level is an effective way to reach hard-to-reach populations, according to a study of active TB case finding conducted in Umzinyathi in KwaZulu-Natal, South Africa.
Thirty-seven semi-literate volunteer community care workers screened 1665 people in approximately 400 households for the signs and symptoms of TB and diabetes using an 11-question tick sheet comprising questions about close TB contacts within the last year, persistent cough for more than two weeks, night sweats, weight loss, excessive tiredness and standard HIV and diabetes questions. The community care workers were instructed to go to households where they knew people to be sick.
According to the study presenter Dr Derek Turner of the Umvoti AIDS Centre, Greytown, Kwazulu Natal, caregivers are able to convince community members to go to primary health care facilities when signs and symptoms of TB are present, get people to disclose previous TB and HIV statuses and get access to TB record cards for recording treatment start dates and outcomes and also consistently fill in the screening tool.
Of the 1665 people screened, a high percentage (39.8%) were males. Men are traditionally harder to reach and less likely to access health services. Three hundred and fifty people showed signs and symptoms of TB and were referred to primary health clinics for TB testing, 247 of which had either no visit to a health facility or an uncertain outcome reported by care givers.
Of the 103 that were successfully referred to a public health care facility, 36 started TB treatment (20 females and 16 males) and 17 have completed treatment to date.
Twenty-nine people were already confirmed as having TB and on treatment, five of which had been on treatment for more than one year. One of the cases of those on treatment for more than a year has been diagnosed with multi-drug resistant TB and has started second-line treatment. Two people with known TB who had refused treatment were identified. 109 people had been in close contact with a person with TB in the last year.
“The simplicity and non-threatening nature of the intervention is instrumental in getting traditionally hard-to-reach people, particularly men, to answer questions and access care,” said Dr Turner.
Source:1
