Title:
Factors Contributing to Low Tuberculosis Case Finding in Zimbabwe: New Challenges Demand Innovative Approaches
Authors:
Ngwenya, Mkhokheli
Year:
2015
PAGE:
xiii, 83
Language:
En
Keywords:
Tuberculosis, TB, Zimbabwe, Symptoms, Prevalence, Survey, Low Case Detection
Abstract:
Tuberculosis (TB) remains a major public health problem in Zimbabwe and the country is not on track to meet the Millennium Development Goals (MDGs) targets. In 2013, the estimated incidence, prevalence and mortality in Zimbabwe was estimated at 552(95%CI 474-643), 409(95%CI 235-630) and 193(95%CI 146-241)/100,000 population, respectively. Persistently low estimated case detection rates and sustained decline of notifications over the past few years is of concern. While this decline may be due to a real decline in incidence, there have been concerns over poor case detection. Exploration of factors contributing to low case detection was done through literature review and analysis of data from National TB Prevalence Survey (NTPS) conducted in 2014. Findings indicate that as much as 43% of bacteriologically positive (Bac+) cases [22% for sputum smear positive (SS+)] in the community are symptom free and there is a large gap between SS+ and Bac+ TB. Non-tuberculous mycobacteria (NTMs) were also shown to complicate diagnosis and management of TB cases. Significant challenges exist in ensuring early diagnosis of TB in the country. Provinces and districts with low case notification rates may be missing a number of cases in the community. A review of current case finding strategies, tools and algorithms is recommended in order to improve case detection. Capacity strengthening targeted at provinces and districts which traditionally report fewer cases may have increased yield of Bac+. NTM burden and effects on TB diagnosis and management needs to be explored further.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Country:
Zimbabwe
Region:
Southern Africa
Training:
Master of Public Health / International Course in Health Development (MPH/ICHD)
Category:
Research
Right:
© 2015 Ngwenya
Document type:
Thesis/dissertation
File:
tmeYzLwqso_20161103082635852.pdf