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

Yared Merid; Yimtubezinash Woldeamanuel Mulate; Mesay Hailu; Tsegaye Hailu; Getnet Habtam; Markos Abebe; Daniel Datiko; Abraham Aseffa

doi:10.1016/j.ijid.2019.10.012

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

Yared Merid, Yimtubezinash Woldeamanuel Mulate, Mesay Hailu, Tsegaye Hailu, Getnet Habtam, Markos Abebe, Daniel Datiko, Abraham Aseffa

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

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.

Original language	English
Pages (from-to)	122-127
Number of pages	6
Journal	International Journal of Infectious Diseases
Volume	89
Early online date	19 Oct 2019
DOIs	https://doi.org/10.1016/j.ijid.2019.10.012
Publication status	Published - 1 Dec 2019
Externally published	Yes

Keywords

Community TB
Ethiopia
Health development army
Prevalence

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.ijid.2019.10.012Licence: CC BY-NC-ND

1-s2Accepted author manuscript, 2.05 MBLicence: CC BY

Cite this

@article{47895235c4224bcb8ed04b0a6f2f6262,

title = "Population-based Screening for Pulmonary Tuberculosis utilizing Community Health Workers in Ethiopia",

abstract = "ObjectiveTo evaluate the utility of a volunteer health development army in conducting population screening for active TB in a rural community in Southern Ethiopia.MethodsA 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.ResultsAll 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.ConclusionWe 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.",

keywords = "Community TB, Ethiopia, Health development army, Prevalence",

author = "Yared Merid and Mulate, \{Yimtubezinash Woldeamanuel\} and Mesay Hailu and Tsegaye Hailu and Getnet Habtam and Markos Abebe and Daniel Datiko and Abraham Aseffa",

year = "2019",

month = dec,

day = "1",

doi = "10.1016/j.ijid.2019.10.012",

language = "English",

volume = "89",

pages = "122--127",

journal = "International Journal of Infectious Diseases",

issn = "1201-9712",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Population-based Screening for Pulmonary Tuberculosis utilizing Community Health Workers in Ethiopia

AU - Merid, Yared

AU - Mulate, Yimtubezinash Woldeamanuel

AU - Hailu, Mesay

AU - Hailu, Tsegaye

AU - Habtam, Getnet

AU - Abebe, Markos

AU - Datiko, Daniel

AU - Aseffa, Abraham

PY - 2019/12/1

Y1 - 2019/12/1

N2 - ObjectiveTo evaluate the utility of a volunteer health development army in conducting population screening for active TB in a rural community in Southern Ethiopia.MethodsA 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.ResultsAll 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.ConclusionWe 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.

AB - ObjectiveTo evaluate the utility of a volunteer health development army in conducting population screening for active TB in a rural community in Southern Ethiopia.MethodsA 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.ResultsAll 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.ConclusionWe 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.

KW - Community TB

KW - Ethiopia

KW - Health development army

KW - Prevalence

U2 - 10.1016/j.ijid.2019.10.012

DO - 10.1016/j.ijid.2019.10.012

M3 - Article

SN - 1201-9712

VL - 89

SP - 122

EP - 127

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

ER -

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

Abstract

Keywords

UN SDGs

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