Community-based active tuberculosis case finding using a symptom-based screening tool in the Volta Region, Ghana

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Tuberculosis Control

Background:

• Early tuberculosis case detection is crucial for treatment and preventing community spread.
• Ghana lacks data on the effectiveness of symptom-based screening (SBS) tools for Mycobacterium tuberculosis detection.
• This study evaluated the SBS tool for community-based active case finding in Ghana's Volta Region.

Purpose of the Study:

• To assess the utility of the symptom-based screening (SBS) tool for active tuberculosis case finding in the Volta Region of Ghana.
• To compare the effectiveness of house-to-house versus community durbar screening approaches.

Main Methods:

• A cross-sectional study involving house-to-house and community durbar screening in high and low TB risk districts.
• Participants were screened using the SBS tool to identify presumptive tuberculosis cases.
• Sputum samples from presumptive cases were analyzed using the GeneXpert real-time technique for Mycobacterium tuberculosis detection.

Main Results:

• Out of 1,025 screened individuals, 332 (32.4%) were presumptive TB cases.
• House-to-house screening identified 63.9% of presumptive cases, while durbar screening identified 36.1%.
• Six Mycobacterium tuberculosis-positive cases were detected, including one with rifampicin resistance, all via house-to-house screening. Overall prevalence was 15 per 100,000.

Conclusions:

• Community-based active case finding using the SBS tool is effective for detecting Mycobacterium tuberculosis.
• House-to-house screening, though resource-intensive, demonstrated higher effectiveness in case detection compared to community durbars.