Implementation of an Effective Decentralised Programme for Detection, Treatment and Prevention of Tuberculosis in...

Area of Science:

• Public Health
• Infectious Diseases
• Pediatrics

Background:

• Childhood tuberculosis (TB) remains under-detected in high-burden nations like Uganda, particularly in young children.
• Limited access to specialized services at the referral level hinders effective prevention, detection, and treatment of pediatric TB.
• Implementation of TB preventive treatment (TPT) for child contacts is notably suboptimal.

Purpose of the Study:

• To describe the development and implementation of the DETECT Child TB Project in Uganda.
• To evaluate the impact of decentralizing child TB services on case finding, treatment outcomes, and TPT uptake.
• To identify challenges and lessons learned from a community-based approach to childhood TB management.

Main Methods:

• Decentralization of child TB services from tertiary to primary healthcare facilities.
• Integration of community-based household contact screening and management.
• Provision of ongoing mentorship and practical support for healthcare workers.

Main Results:

• Improved case finding for both childhood and adult TB cases.
• Enhanced treatment outcomes for children diagnosed with TB.
• High uptake and completion rates for TB preventive treatment (TPT) among eligible child contacts.

Conclusions:

• Decentralizing healthcare services and strengthening community linkages are effective strategies for improving childhood TB detection and management.
• Ongoing support and mentorship for healthcare workers are crucial for successful implementation of TB programs.
• The DETECT Child TB Project demonstrated a successful model for addressing childhood TB in resource-limited settings.