Abstract
BackgroundTuberculosis (TB) continues to pose a major public health problem globally. In Ghana, the national TB case detection rate is 81 %; however, some districts are not able to meet their case detection targets. This study was therefore carried out in the Nkwanta South district to identify possible factors contributing to low TB case detection.MethodsA cross sectional descriptive study involving the review of outpatients records for the year 2012 was conducted. Data on cough for 2 weeks or more duration, age, sex, area of residence and sputum smear examination were extracted. A community-based survey involving household contacts of TB patients and community based volunteers was also carried out. Data collected in the community included knowledge of TB status of relatives, level of socialization with TB patients and signs and symptoms of TB disease. Descriptive statistics including cross-tabulations were used to identify possible factors contributing to low TB case detection.ResultsA total of 932 patients out of 3987 reported coughing for 2 weeks or more (23.4 %; 932/3987). Out of that, only 24.6 % (230/932) had sputum smear microscopy done, yielding 57 (24.8 %) positive cases. Five out of the 57 positive cases were found not registered for the initiation of treatment leading to a false primary default rate of 8.8 % per year. Eighty-five percent of the contacts were able to mention persistent cough as a sign/symptom of TB with 80.4 % indicating that TB can be cured. Only 10 % of health facilities provided diagnostic services in the district with only 25 % of staff having had training in TB management.ConclusionThe study identified some factors (weak record review systems, inadequate diagnostic centres, lack of trained persons and some level of stigma at the community level) that could be contributing to low TB case detection in the Nkwanta South district.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2136-x) contains supplementary material, which is available to authorized users.
Highlights
Tuberculosis (TB) continues to pose a major public health problem globally
The analysis was based on 3987 records after incomplete records [513/4500, 11.4 %] were removed from the dataset
A total of 932 patients (23.38 %) presented with cough of 2 weeks or more duration at the out patient department (OPD); sputum smear microscopy was done for only 24.68 % (230/932) of them, with as many as 702 (75.4 %) of the cough cases going back home without further laboratory investigation for Mycobacterium tuberculosis infection [p < 0.0001] (Table 1)
Summary
Tuberculosis (TB) continues to pose a major public health problem globally. In Ghana, the national TB case detection rate is 81 %; some districts are not able to meet their case detection targets. Human tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis. The infection is transmitted from person to person via droplets from the throat and lungs of people with active respiratory disease [1]. The disease ranks second in terms of mortality from a single infectious agent, after the human. TB case detection rate has stagnated at around 60 % and has still not reached the 70 % target set for 2005 [6] with sub-Sahara Africa having a much lower rate of 52 % [3]. Poor TB case detection leads to increased transmission and high TB prevalence rates, as each active case has the capacity to infect 10–15 people per year [7]. At the primary health care delivery level resources including human, for sputum smear examination for acid fast Bacilli (AFB) is usually not available. Most cases of pulmonary tuberculosis are diagnosed based on clinical and radiological indicators [8]
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