Introduction: World Health Organization recommends screening of household contact
as a key to improve detection of tuberculosis cases. Ethiopia’s current tuberculosis
household contact investigation strategies rely on symptomatic contacts attending health
facilities for investigation. This approach has not led to the detection of additional
tuberculosis (TB) cases; alternative approaches have to be considered. The purpose of
the research was to develop guidelines in endorsing the implementation of a community
based household contact investigation program in Addis Ababa.
Methods: A mixed method research using sequential exploratory design was conducted
in Addis Ababa. In the first phase, qualitative data collection and analysis methods were
used to formulate intervention approach and in the second phase, a quantitative random
controlled trial was conducted, with the purpose of comparing the proposed intervention
measures with routine household contact tuberculosis investigation. Frequencies and
logistic regression analyses were used to determine the relative risk and associated
factors. Thematic analysis was used for qualitative data analysis.
Results: The in-depth interview and focus group discussion findings identified themes
namely household contact investigation (HHCI) implementation, misconceptions on
HHCI, challenges with HHCI Approaches, opportunities for HHCI provision, contributing
factors associated with household involvement, strategies for effective HHCI service and
partnerships with health bureau. In phase two, the study reported that the prevalence of
TB was 7.1% among the intervention group compared to 1.9% in the control groups at
the end of first year follow-up. Nine guidelines were developed to support the household
contact investigation system.
Conclusion: The passive case detection strategy of contact investigation did not find
more cases, and tuberculosis patients and their family contacts were not satisfied with
this method. However, the proposed community-based strategy shows that more TB
cases can be detected by using existing medical staff. Therefore, an approach that makes
the service more accessible is significant and the recommended community based TB
household contact tracing approaches needs to be scaled up for its performance towards
identified missed cases and enhance patient and their household contacts involvement. / Health Studies / D. Litt. et Phil. (Public Health)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:unisa/oai:uir.unisa.ac.za:10500/27816 |
| Date | 08 1900 |
| Creators | Zerihun Yaregal Admassu |
| Contributors | Nkosi, Z. Z. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 1 online resource (xiii, 179 leaves) : color illustrations, color graphs, application/pdf |
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