Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.

There is a large gap between the number of people who develop tuberculosis (TB) and those who are diagnosed, treated and notified, with only an estimated 71% of people with TB notified globally in 2019. Implementing better TB case finding strategies is necessary to close this gap. In Cameroon, 1,597...

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Main Authors: Zourriyah Adamou Mana, Chrysal Ngouateu Beaudou, Kamga Fotue Jean Hilaire, Joceline Konso, Carole Ndahbove, Yvonne Waindim, Maurice Ganava, Toussaint Malama, Christian Matip, Paul Meoto, Irene Adeline Goupeyou Wandji, Mercy Fundoh, Cyrille Mbuli, Vuchas Comfort, Pride Teyim, Sandra Alba, Jacob Creswell, Vincent Mbassa, Melissa Sander
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0000301
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author Zourriyah Adamou Mana
Chrysal Ngouateu Beaudou
Kamga Fotue Jean Hilaire
Joceline Konso
Carole Ndahbove
Yvonne Waindim
Maurice Ganava
Toussaint Malama
Christian Matip
Paul Meoto
Irene Adeline Goupeyou Wandji
Mercy Fundoh
Cyrille Mbuli
Vuchas Comfort
Pride Teyim
Sandra Alba
Jacob Creswell
Vincent Mbassa
Melissa Sander
author_facet Zourriyah Adamou Mana
Chrysal Ngouateu Beaudou
Kamga Fotue Jean Hilaire
Joceline Konso
Carole Ndahbove
Yvonne Waindim
Maurice Ganava
Toussaint Malama
Christian Matip
Paul Meoto
Irene Adeline Goupeyou Wandji
Mercy Fundoh
Cyrille Mbuli
Vuchas Comfort
Pride Teyim
Sandra Alba
Jacob Creswell
Vincent Mbassa
Melissa Sander
author_sort Zourriyah Adamou Mana
collection DOAJ
description There is a large gap between the number of people who develop tuberculosis (TB) and those who are diagnosed, treated and notified, with only an estimated 71% of people with TB notified globally in 2019. Implementing better TB case finding strategies is necessary to close this gap. In Cameroon, 1,597 healthcare workers at 725 health facilities were trained and engaged to intensively screen and test people for TB, then follow-up to link people to appropriate care. Primary care centers were linked to TB testing through a locally-tailored specimen referral network. This intervention was implemented across 6 regions of the country, with a population of 16 million people, while the remaining 4 regions in the country, with 7.3 million people, served as a control area. Controlled interrupted time series analyses were used to compare routinely-collected programmatic TB case notification rates in the intervention versus control area for 12 quarters prior to (2016-2018) and for 8 quarters after the start of the intervention (2019-2020). In 2019-2020, a total of 167,508 people were tested for TB at intervention sites, including 52,980 people attending primary care facilities that did not previously provide organized TB services. The number of people tested for TB increased by 45% during the intervention as compared to prior to the intervention. The controlled interrupted time series analyses showed that after two years of the intervention, the all-forms TB case notification rate in the intervention population increased by 9% (ratio of case notification rate ratios = 1.09, 95% CI 1.06 to 1.12), as compared with the counterfactual estimated from pre-intervention trends. This increase was observed even during a negative national impact on case finding from the COVID-19 pandemic. These results support the use of this health-facility based intervention to improve access to TB testing and care in this setting.
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spelling doaj.art-8af47c9432c647c79020e35273c3739c2023-09-03T09:58:53ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0127e000030110.1371/journal.pgph.0000301Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.Zourriyah Adamou ManaChrysal Ngouateu BeaudouKamga Fotue Jean HilaireJoceline KonsoCarole NdahboveYvonne WaindimMaurice GanavaToussaint MalamaChristian MatipPaul MeotoIrene Adeline Goupeyou WandjiMercy FundohCyrille MbuliVuchas ComfortPride TeyimSandra AlbaJacob CreswellVincent MbassaMelissa SanderThere is a large gap between the number of people who develop tuberculosis (TB) and those who are diagnosed, treated and notified, with only an estimated 71% of people with TB notified globally in 2019. Implementing better TB case finding strategies is necessary to close this gap. In Cameroon, 1,597 healthcare workers at 725 health facilities were trained and engaged to intensively screen and test people for TB, then follow-up to link people to appropriate care. Primary care centers were linked to TB testing through a locally-tailored specimen referral network. This intervention was implemented across 6 regions of the country, with a population of 16 million people, while the remaining 4 regions in the country, with 7.3 million people, served as a control area. Controlled interrupted time series analyses were used to compare routinely-collected programmatic TB case notification rates in the intervention versus control area for 12 quarters prior to (2016-2018) and for 8 quarters after the start of the intervention (2019-2020). In 2019-2020, a total of 167,508 people were tested for TB at intervention sites, including 52,980 people attending primary care facilities that did not previously provide organized TB services. The number of people tested for TB increased by 45% during the intervention as compared to prior to the intervention. The controlled interrupted time series analyses showed that after two years of the intervention, the all-forms TB case notification rate in the intervention population increased by 9% (ratio of case notification rate ratios = 1.09, 95% CI 1.06 to 1.12), as compared with the counterfactual estimated from pre-intervention trends. This increase was observed even during a negative national impact on case finding from the COVID-19 pandemic. These results support the use of this health-facility based intervention to improve access to TB testing and care in this setting.https://doi.org/10.1371/journal.pgph.0000301
spellingShingle Zourriyah Adamou Mana
Chrysal Ngouateu Beaudou
Kamga Fotue Jean Hilaire
Joceline Konso
Carole Ndahbove
Yvonne Waindim
Maurice Ganava
Toussaint Malama
Christian Matip
Paul Meoto
Irene Adeline Goupeyou Wandji
Mercy Fundoh
Cyrille Mbuli
Vuchas Comfort
Pride Teyim
Sandra Alba
Jacob Creswell
Vincent Mbassa
Melissa Sander
Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.
PLOS Global Public Health
title Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.
title_full Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.
title_fullStr Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.
title_full_unstemmed Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.
title_short Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.
title_sort impact of intensified tuberculosis case finding at health facilities on case notifications in cameroon a controlled interrupted time series analysis
url https://doi.org/10.1371/journal.pgph.0000301
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