Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches
Abstract Background Tuberculosis related deaths remain a priority globally. Despite advancements in TB care, access to quality care remains inequitable to the disadvantage of those in rural and urban informal settlements. The Awareness, Traditions, and Innovation in combating Tuberculosis (ATI TB) p...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-17631-2 |
| _version_ | 1797355418179076096 |
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| author | Gianfranco Morino Caleb Mike Mulongo Paolo Cattaneo Maria Vittoria De Vita Gabriele Paone Simone Scarlata Federico Gobbi Salome Kinyita Hillary Odhiambo |
| author_facet | Gianfranco Morino Caleb Mike Mulongo Paolo Cattaneo Maria Vittoria De Vita Gabriele Paone Simone Scarlata Federico Gobbi Salome Kinyita Hillary Odhiambo |
| author_sort | Gianfranco Morino |
| collection | DOAJ |
| description | Abstract Background Tuberculosis related deaths remain a priority globally. Despite advancements in TB care, access to quality care remains inequitable to the disadvantage of those in rural and urban informal settlements. The Awareness, Traditions, and Innovation in combating Tuberculosis (ATI TB) project incorporated active case finding (ACF), use of GeneXpert technology and decentralized services to improve TB care in Kajiado County. This study sought to establish the impact of the project as well as implementation lessons learnt during its tenure in Kajiado County, Kenya. Methods This evaluation adopted a mixed-methods approach with retrospective cohort analysis for the quantitative data and qualitative data sought through key informant interviews with 28 purposively sampled respondents. The qualitative data was analyzed thematically using Taguette while quantitative data was analyzed using R Software yielding descriptive statistics and measures of association. Results While the males were a minority among the presumptive cases (623; 46%), they were the majority (59.3%) among the confirmed TB cases. 70% of the confirmed cases were aged between 15 and 44 years; with those aged between 25- and 34-years being majority (30% of the cases). Majority of the confirmed cases within the project were from rural Kajiado West (79; 66.9%). Though 61% of the presumptive cases were through ACF, only 7% of these tested positive. Conversely, 13% of the self-referrals tested positive. 53% (66) of the positive cases with valid data were self-referrals while ACF accounted for 47% (58) of the positives. Conclusion Continued capacity development among health workers, sustained and targeted sensitization and screening among vulnerable groups, strategic collaborations, alongside increased budgetary prioritization of health and TB care by government and partners, and government investments in Social Determinants of Health can ensure gains in TB care are sustained. |
| first_indexed | 2024-03-08T14:10:46Z |
| format | Article |
| id | doaj.art-21a9890b963449ebb7ce658978706f44 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T14:10:46Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-21a9890b963449ebb7ce658978706f442024-01-14T12:41:44ZengBMCBMC Public Health1471-24582024-01-0124111010.1186/s12889-023-17631-2Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approachesGianfranco Morino0Caleb Mike Mulongo1Paolo Cattaneo2Maria Vittoria De Vita3Gabriele Paone4Simone Scarlata5Federico Gobbi6Salome Kinyita7Hillary Odhiambo8World Friends OnlusHealth Systems Unit, Tunu Consulting HubDepartment of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di ValpolicellaWorld Friends OnlusWorld Friends OnlusUnit of internal medicine, Respiratory pathophysiology and thoracic endoscopy, Fondazione Policlinico Universitario Campus Bio MedicoDepartment of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di ValpolicellaHealth Systems Unit, Tunu Consulting HubHealth Systems Unit, Tunu Consulting HubAbstract Background Tuberculosis related deaths remain a priority globally. Despite advancements in TB care, access to quality care remains inequitable to the disadvantage of those in rural and urban informal settlements. The Awareness, Traditions, and Innovation in combating Tuberculosis (ATI TB) project incorporated active case finding (ACF), use of GeneXpert technology and decentralized services to improve TB care in Kajiado County. This study sought to establish the impact of the project as well as implementation lessons learnt during its tenure in Kajiado County, Kenya. Methods This evaluation adopted a mixed-methods approach with retrospective cohort analysis for the quantitative data and qualitative data sought through key informant interviews with 28 purposively sampled respondents. The qualitative data was analyzed thematically using Taguette while quantitative data was analyzed using R Software yielding descriptive statistics and measures of association. Results While the males were a minority among the presumptive cases (623; 46%), they were the majority (59.3%) among the confirmed TB cases. 70% of the confirmed cases were aged between 15 and 44 years; with those aged between 25- and 34-years being majority (30% of the cases). Majority of the confirmed cases within the project were from rural Kajiado West (79; 66.9%). Though 61% of the presumptive cases were through ACF, only 7% of these tested positive. Conversely, 13% of the self-referrals tested positive. 53% (66) of the positive cases with valid data were self-referrals while ACF accounted for 47% (58) of the positives. Conclusion Continued capacity development among health workers, sustained and targeted sensitization and screening among vulnerable groups, strategic collaborations, alongside increased budgetary prioritization of health and TB care by government and partners, and government investments in Social Determinants of Health can ensure gains in TB care are sustained.https://doi.org/10.1186/s12889-023-17631-2GeneXpertTuberculosisActive case findingPatient-centred Tuberculosis careDecentralized Tuberculosis care |
| spellingShingle | Gianfranco Morino Caleb Mike Mulongo Paolo Cattaneo Maria Vittoria De Vita Gabriele Paone Simone Scarlata Federico Gobbi Salome Kinyita Hillary Odhiambo Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches BMC Public Health GeneXpert Tuberculosis Active case finding Patient-centred Tuberculosis care Decentralized Tuberculosis care |
| title | Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches |
| title_full | Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches |
| title_fullStr | Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches |
| title_full_unstemmed | Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches |
| title_short | Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community approaches |
| title_sort | finding the missing many improving tuberculosis care in kajiado county through active case finding and community approaches |
| topic | GeneXpert Tuberculosis Active case finding Patient-centred Tuberculosis care Decentralized Tuberculosis care |
| url | https://doi.org/10.1186/s12889-023-17631-2 |
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