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Tuberculosis contact tracing, Angola
Joan Martínez-Campreciós1, Eva Gil1, Sandra Aixut1
1International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d'Hebron 119, 08035Barcelona, Spain.
Bulletin of the World Health Organization
|February 29, 2024
Summary
Contact tracing in Angola improved tuberculosis diagnosis, but low engagement and high loss to follow-up were challenges. Community-based approaches may enhance participation and diagnosis rates for tuberculosis.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Global Health
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly in low-resource settings.
- Effective contact tracing is crucial for early diagnosis and interruption of TB transmission.
- Angola faces a high burden of tuberculosis, necessitating robust public health interventions.
Purpose of the Study:
- To evaluate the outcomes of a health center-based tuberculosis contact tracing program in Cubal, Angola.
- To assess the program's effectiveness in increasing TB diagnosis and offering preventive treatment.
- To identify factors influencing program participation and treatment completion.
Main Methods:
- A retrospective analysis of a contact tracing program from March 2015 to 2022.
- Categorization of program activities into four distinct periods based on staffing and testing availability.
- Assessment of contact evaluation, testing uptake, and treatment initiation rates across different program phases.
Main Results:
- The program evaluated 1978 contacts from 969 index cases, with low overall participation.
- Chest radiograph uptake was 16.6%, and 10.1% of contacts received TB treatment.
- Microbiological confirmation improved to 72.2% with molecular testing; 7.9% of young children received preventive treatment.
Conclusions:
- Contact tracing increased TB diagnosis but faced challenges with low engagement and high loss to follow-up.
- Community Directly Observed Treatment (DOT) periods showed increased participation.
- Community-based screening strategies should be explored to improve TB program effectiveness.
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