Finding the missing many: improving Tuberculosis care in Kajiado county through active case finding and community...

Area of Science:

• Public Health
• Infectious Disease Control
• Health Systems Strengthening

Background:

• Tuberculosis (TB) remains a global health priority, with significant disparities in care access, particularly for populations in informal settlements.
• The Awareness, Traditions, and Innovation in combating Tuberculosis (ATI TB) project aimed to address these inequities in Kajiado County, Kenya.

Purpose of the Study:

• To evaluate the impact of the ATI TB project on tuberculosis care in Kajiado County.
• To identify implementation lessons learned from the project's interventions, including active case finding (ACF) and GeneXpert technology.

Main Methods:

• A mixed-methods approach was employed, combining retrospective cohort analysis of quantitative data with qualitative data from key informant interviews.
• Quantitative data were analyzed using R Software, while qualitative data underwent thematic analysis using Taguette.

Main Results:

• Males constituted a minority of presumptive cases but a majority of confirmed TB cases (59.3%).
• The majority of confirmed TB cases (70%) were aged 15-44 years, with a peak incidence in the 25-34 age group.
• Self-referrals (53%) were more successful in identifying positive TB cases compared to active case finding (47%), despite ACF yielding 61% of presumptive cases.

Conclusions:

• Sustaining TB care gains requires ongoing health worker capacity development, targeted screening of vulnerable groups, and strategic collaborations.
• Increased government and partner budgetary prioritization for TB care and investments in Social Determinants of Health are crucial for long-term success.