Community tuberculosis screening, testing and care, Uganda.

Area of Science:

• Public Health
• Infectious Disease Control
• Community Health Interventions

Background:

• Tuberculosis (TB) and leprosy remain significant global health challenges, necessitating effective community-based screening strategies.
• Door-to-door screening and contact tracing are vital components of infectious disease control programs in resource-limited settings.

Purpose of the Study:

• To evaluate the effectiveness of a community-based intervention for tuberculosis and leprosy.
• To assess the impact of village health teams and health workers conducting door-to-door screening, targeted screenings, and contact tracing.

Main Methods:

• A before-and-after implementation study was conducted in Uganda.
• Two campaign periods (March 2022 and September 2022) were analyzed for reach, outputs, adoption, and effectiveness.
• Case notification rates were compared to the previous year, and leprosy screening outcomes were assessed.

Main Results:

• Campaign 1 screened over 1.2 million people, identifying 4043 TB cases, with a 24% increase in case notification rate.
• Campaign 2 screened over 5.1 million people, identifying 8121 TB cases, with a 59% increase in case notification rate.
• Leprosy screening identified 176 patients, with 77.8% initiating treatment.

Conclusions:

• The community tuberculosis screening initiative proved effective in increasing case detection.
• Continuous monitoring and context-specific adaptations are essential for overcoming implementation challenges.
• The study highlights the potential of integrated community-based approaches for managing TB and leprosy.