Tuberculosis: Community System Strengthening Will Improve Case Finding – Experts

BY Fidelis Akahomen

With Nigeria ranked among the WHO TB high burden countries and with about 75 percent undetected TB cases in communities, health experts have called for the integration and adoption of Community Systems Strengthening (CSS) for effective and improved case finding.

The experts made the call during the Civil Society Accountability Forum 2020 virtual pre-conference, organized in collaboration with ‘Stop TB Partnership Nigeria’, tagged “Integrating Community Systems Strengthening (CSS) for effective HIV, TB, malaria and COVID-19 response in Nigeria.

Gathered from a slide released from the forum, Community System Strengthening (CSS) is about the roles of key affected populations and communities, community organizations, public and private sector actors that work in partnership with civil society at community level, in the design, delivery, monitoring and evaluation of services and activities aimed at improving health outcomes. Components of CSS include: enabling environment and advocacy, community linkages, partnership and coordination, resources and capacity building, amongst other.

The Board Chair of the ‘Stop TB Nigeria’, Dr. Ayodele Awe revealed from a survey carried out in 2012, that 75 percent of TB cases are still undetected in communities, and therefore reiterated the need for community strengthening and partnership with Civil Society Organizations (CSOs) at the community level in the fight against the deadly bacteria.

“For us in TB, community level is the operational level for TB and the level for the integration of diseases.

“It is at this level that we were told in a previous survey carried out in 2012 on TB, that 75 per cent of the TB cases that we are not detecting are in the community, coughing, and we don’t know them. “We need to increase our collaborative activities to ensure that we are able to detect cases.
“We are happy that some key civil society organisations are already working at the community level, but we are hoping that there will be a more integrated civil society organisations because we are still not doing well in TB detection at the community level, particularly because of COVID-19 pandemic.” he said.

In a report released by the National TB Programme, community referrals increased by 199 percent when Q1 2019, is compared with Q1 2020, with states engaging community intervention, witnessing increased case findings.

The team lead, National TB and Leprosy Control Programme, Dr Emperor Ubochioma said it was time to co-opt traditional rulers, faith and opinion leaders in the communities to join the advocacy.
‘‘The community is everybody, where we live and people around us, so community entities are needed to support the process of finding, treating and managing cases. If there is no support from the community, interventions cannot be possible. We have to develop strategies that will support activities of CSOs’’, he said.

Speaking on the impact of COVID-19 on TB control, National Community TB taskforce, Dr Chijioke Osakwe said: “Lockdown and fear of COVID-19 reduced hospital attendance by almost 50 percent. Some facilities closed down as a result of infection of health workers with COVID-19, while diagnostic efforts reduced significantly.”
Osakwe further said: “It is advisable for a wider range of stakeholders already involved in community-based activities to be engaged in order to reach the unreached and to find TB patients early in the course of their ailment,”

On his part, Executive Director of KNCV TB Foundation Nigeria, Dr. Bethrand Odume, called for a change of strategy tuberculosis.

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