Abstract
Background:Intensified efforts to improve tuberculosis (TB) diagnosis, treatment, and prevention are needed to meet global EndTB targets. Community health workers’ (CHWs) knowledge with respect to case finding is vital in tuberculosis elimination. This study aimed to determine the effect of tuberculosis training on the knowledge of community health workers in Nigeria.Methods:As part of a larger multicomponent intervention study, a randomised control trial was conducted with CHWs in 18 primary health care (PHC) clusters in Nigeria. The clusters were allocated to three arms: training and cash incentive (A), training only (B), and control (C) arms. Arms (A) and (B) received training on tuberculosis symptoms, prevention, diagnosis and treatment while the control arm (C) did not receive training. Participants’ knowledge on tuberculosis was assessed using questionnaires administered pre- and post-intervention. Data was analyzed using GraphPad Prism. Descriptive data was presented in tables and bivariate data was analyzed using chi square. Statistical significance was set as P<0.05.Results:There was a significant increase in the total knowledge score (25.4%), knowledge of general symptoms (24.4%), prevention (22.6%) and diagnosis and treatment (30.0%) across all study arms post-intervention (p<0.0001). Compared with the control arm, the training arm (A) had a higher proportion of good total knowledge score (94.4%) and arm (B) had a lower proportion of good total knowledge score (83.1%) when compared to the control group (93.1%). These were, however, not statistically significant.Conclusions:An improvement in the CHWs’ knowledge of symptoms, prevention, diagnosis and treatment of tuberculosis was observed after a training intervention was done. Integration of routine tuberculosis training is recommended to improve tuberculosis case finding in high burden communities.Pan African Clinical Trial Registry registration:PACTR202010691865364 (14/01/2020)
Highlights
One of the United Nations’ Sustainable Development Goals (SDG) as contained in the SDG target 3.3 is to end the tuberculosis epidemic by the year 2030
A total of 240 Community health workers’ (CHWs) were recruited at baseline and 153 trained, 85 in arm A and 73 in arm B, while 82 were recruited in the control arm[26]
Training was found in Abia state, Nigeria, to improve knowledge among Health workers, but to improve all indicators of the Finding TB cases Actively, Separating safely, and Treating effectively (FAST) strategy which include the time to diagnosis, time to treatment which the time between making a diagnosis and commencement of TB treatment, number of presumptive TB and Drug Resistant TB (DRTB) cases identified and number of TB and DRTB cases commenced on treatment.[20]
Summary
One of the United Nations’ Sustainable Development Goals (SDG) as contained in the SDG target 3.3 is to end the tuberculosis epidemic by the year 2030 This End TB Strategy defines as a targets for 2030, a 90% reduction in the number of TB deaths and an 80% reduction in the TB incidence rate (new cases per 100 000 population per year) compared with levels in 2015.1 Progress in global TB elimination which has been inconsistent in recent years has led to intensified efforts to improve TB diagnosis, treatment, and prevention required to meet global targets for 2020–2035.2 To achieve these set targets, there’s a need for various national tuberculosis programs to have agendas set and implemented towards meeting goals. Conclusions: An improvement in the CHWs’ knowledge of symptoms, Invited Reviewers 1 version 1
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