Nigeria: The Association for Reproductive and Family Health (ARFH) finds more than 17,800 people with TB through active ‘door-to-door’ case finding

Nigeria: The Association for Reproductive and Family Health (ARFH) finds more than 17,800 people with TB through active ‘door-to-door’ case finding

[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_separator type=”normal” thickness=”2″ up=”20″ down=”20″][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_gallery type=”nivo” interval=”3″ images=”1458,1459″ img_size=”full”][vc_column_text]One of the major TB case finding efforts carried out in Nigeria under the Global Fund supported New Funding Model (NFM) TB grant has been the house-to-house approach among slum dwellers. This community-based intervention targeted 365 slums in 87 Local Government Areas in 22 priority states during July – December 2017.

The intervention followed three overarching goals: (1) ensuring that communities have accurate knowledge of TB through community mobilization, sensitization and demand creation for TB/HIV services; (2) accelerating the identification of all forms of TB cases through house-to-house search, contact tracing, sputum collection and transportation to DOTS facilities; as well as (3) increasing the number of patients that are successfully linked to TB & TB/HIV services.

The house-to-house strategy entailed identification of people presumed to have TB by trained Community TB Workers (CTWs) through sputum collection and transportation to diagnostic centers, as well as linkage of patients with confirmed TB with DOTS facilities. The CTWs are being coordinated by Community-Based Organizations (CBOs) who are also responsible for organizing community mobilization and sensitization.

Overall, these efforts resulted in a total of 223,126 presumptive people with TB screened, out of which 17,856 (8%) people with TB were detected. Most recently, this intervention was further being implemented in 5 priority states, benefitting from the extension period Nigeria had obtained for its NFM TB grant from the Global Fund (January – July 2019).

Overcoming barriers to ensure effective door-to-door screening in slums

In most states in the northern part of the country, gender-related barriers were encountered; for instance, males are not allowed to enter certain households, posing a challenge to effective house-to-house screening. To address this issue, trained CTWs have been paired in male-female teams. Furthermore, strategic engagement of community leaders and consensus building dialogue has been very helpful and has achieved cooperation of the intervention communities and ensured acceptance of the trained CTWs.

Additionally, massive awareness creation and sensitization of the population within the slums have helped to reduce stigmatization of TB patients. In order to reinforce this, efforts were made to ensure that communities have accurate knowledge of TB. For example, TB jingles and messages were aired in the local language in selected markets and music shops in the slums, as well as through MP3 players on motorbikes driven by the TB Local Government Supervisors.

Going forward, ARFH will continue to consolidate its active case finding intervention and expand to more slums.[/vc_column_text][/vc_column][/vc_row]