TB Contact Tracing in Motheo District, Free State Province
South Africa
IAS Community Satellite17th July 2011
Dr Ima P. Chima
Acknowledgement Mr. Thomas Sihlangu
– Community Linkages Officer, EGPAF Ms Daphne Mpofu
– Community Linkages Manager, EGPAF Ms Maggie Kwatala
– HIV TB Coordinator Department of Health Free State Ms Keneilwe Nkoana,
– TB Tracing Team from Department of Health Free State Ms Joyce Ramakau
– TB-Free, Free State
Background Motheo District, in Free State Province has the
highest TB case load. In 2009 - case load of 24,940, of which 7, 747
(31.1 %) was in Motheo District only. Department of Health (DoH) in Free State noted ↑
number of new MDR-TB patients based on quarterly data assessments, thus likelihood of Defaulting from TB treatment TB contacts being infected and not seeking treatment
Gupta et al (2010) Maternal TB associated with 2.51 fold ↑ in MTCT of HIV
Prevention of TB among HIV-infected mothers should be high priority for communities with significant HIV/TB burden.
Intervention
TB defaulter tracing in Motheo district Find patients who default or lost to
follow-up Screen contacts for TB and refer them to
the local facilities for further management.
EGPAF in partnership with DOH and TB Free (NGO) started the TB defaulter tracing exercise on 19th January 2011.
Intervention (2) 2468 households were identified from a 2009
register of diagnosed TB patients. Most patients resided in informal settlements Contacts were traced using a number of
ways: Post office staff greatly assisted in locating the
actual houses based on addresses from the register.
Team members asked community members for contacts surnames instead of first names
Teams also used municipality maps to locate house numbers
Intervention (3) Community members were involved
through the participation of Community Health Workers (CHW).
CHW are community members working with CBOs or attached to health facilities.
These CHW together with Lay Counsellors provided HCT.
Community members helped distribute IEC materials and were engaged to assist with mobilization.
Intervention (4) The three partners formed 24 teams
that were allocated different areas to cover in Motheo District.
The teams provided HIV counselling and testing and TB screening, door to door.
Household members gave verbal consent for screening and testing.
Community awareness and mobilisation of the exercise was achieved using road show techniques around “hot spots”.
Intervention (5) Screening for TB was done with a
screening tool (4 questions) and sputum testing .
HIV testing was done using Rapid HIV testing kits
Those HIV +ve were referred to health facilities for CD4 counts
Infants and children below 5 years were excluded from TB screening because of their inability to produce sputum
TB Screening tool
ResultsIndicator Number
Number of households visited 2470
Number of defaulters traced 145
Number of TB patients lost to follow up 73
Number of contacts screened for both HIV and TB 4865
Number of adults sputum positive for TB 12
Number of children sputum positive for TB 24
Number of adults who tested HIV positive (>15 years) 133
• Females 102
• Males 31
Number of children who tested HIV positive (5 to 15 years)
5
Recommendations
Involving post office workers was an effective means of identifying defaulters and patients lost to follow-up especially in informal settlements
The partnership created between EGPAF, DOH and TB-Free was effective and efficient: Combined resources Coordination Ownership by DOH Community mobilisation and awareness
Further research
Further research would assist in evaluating Effectiveness of various community level
interventions in promoting adherence and decreasing default among patients on HIV and TB treatment
Adherence and outcomes of traced defaulters identified through the tracing exercise
Outcomes of contacts identified post tracing
Rea Lebogha!Siyabonga!
Dankie!Thank you!
Top Related