West Africa AIDS Foundation’s (WAAF) Community Systems Strengthening Project (CSS) is to provide contact tracing for health facilities registered Tuberculosis (TB) clients.
TB Contact Tracing is by national guidelines to be done for each positive TB client. Due to recent amendment in the TB funding resulting in limited resources for health facilities to conduct these necessary and important activities, many facilities put the contact tracing on hold. WAAF through the CSS project assigned a team to offer support in TB contact tracing for 10 district hospitals in 9 districts within Greater Accra Region.
After introduction of the project activity to the facilities, WAAFs TB focal person was contacted by 5 of the facilities with request of collaboration with the contact tracing.
During a two months period WAAF has undertaken 7 days of contact tracing activities.
38 TB clients (index case) has been visited to identify their contacts, to conduct TB screening for each contact followed by TB testing (sputum collection) for contact presumptive of TB disease.
A total of 74 contacts were identified and screened based on the national standardized symptoms based screening tool.
Out of the 74 contacts the team screened, 20 contacts were categorized as presumptive (or eligible) TB cases. This means that outcome of the screening questioners on signs and symptoms the contact has history of cough with or without other TB symptoms. When this is the result the team will request a sputum sample from the contact which will be brought to the laboratory for further testing of tuberculosis.
Some contact will find it very difficult to produce a good sputum sample at the visit time, then they will be given the container with instruction of providing a sample early morning for then to bring it to the facility for testing.
Only 9 of the 20 presumptive contact produced sample that was brought to the lab for testing. Out of these 9 samples, all tested negative to TB. Some of the contact could not produce sputum at the time of visit, and they never brought a sample to the facility at a later time as adviced.
No contact has so far been diagnosed with TB from the activities undertaken, but a lot of education on TB has been provided and client has been followed up by the facilities TB team. Most likely many of the contacts who has been highly exposed to the tuberculosis bacilli might develop symptoms at a later point of time, so we believe the awareness and counselling they have received will empower them to report early if/when symptoms occur.
Overall, the activities have been very successful, the challenges make us more creative and motivated for the work, we keep tracing making sure we don’t leave any contact missed out of a possible TB disease.