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Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

Advances in Infectious Diseases 2018年第4期8卷 173-199页

作者： Okorie Onuka Ikpeazu Okezie John Ahukanna Chukwudi Okebaram Patrick Dakum Aderonke Agbaje Vivian Ibeziako Gidado Mustapha Nkem Chukwueme Emperor Ubochioma Amarachi Okorie Nwafor Charles chux anago TB Control Program Ministry of Health Abia State Nigeria Abia State Government House Umuahia Abia State Nigeria Ministry of Health Abia State Nigeria Department of Pharmacology and Therapeutics Abia State University Uturu Nigeria Institute of Human Virology Abuja Nigeria KNCV Abuja Nigeria National TB Control Program Abuja Nigeria School of Midwifery Ministry of Health Umuahia Nigeria GLRA Enugu Enugu Nigeria Clinton Health Access Initiative Abuja Nigeria

Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Nigeria is one of the countries with high incidence and prevalence of TB. The late and low case detection has been a major problem with National TB control program, caused by passive case finding strategy practiced by the country. A shift from the passive and active case search has been recommended for detection of missing cases of TB and improved program performance. The proximity of TB contact is a major determinant of disease transmission. However, maximizing early case detection and prompt treatment of notified cases is very useful in (TB) control especially in high burden countries. The tracking of TB contacts provides a good platform for early diagnosis, educating the household on TB disease and infection control as well as breaking the chain of transmission. The objective of the study is to ascertain effectiveness of contact tracing on Tuberculosis case detection. The study is a retrospective quasi experimental with quantitative arm. The study was conducted in Abia State, one of the South Eastern States of Nigeria. A pre-tested questionnaire was used for data collection and analyzed with SPSS. A total of 168 and 162 index cases of TB were recruited for both intervention and control facilities. The 168 index TB cases yielded 301 TB contacts. The result revealed 55% contact/index ratio, presumptive TB yield of 130 (43.2%) and TB yield of 68 (22.6%). The cases registered in the State increased from 336 to 417 and p value = 0.001, while presumptive TB and BCG vaccination were major predictors. The study shows that tracing contact of index TB cases is an effective and complementary method of finding undetected cases of TB.

关键词： Contact tracing Index TB cases

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A Case Study of Multi Drug-Resistant Tuberculosis (MDR-TB), HIV and Diabetes Mellitus (Dm) Comorbidity: Triple Pathology;Challenges and Prospects

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Advances in Infectious Diseases 2017年第3期7卷 70-79页

作者： Okorie Onuka John Ahukanna Chukwudi Okebaram Patrick Dakum Aderonke Agbaje Vivian Ibeziako Gidado Mustapha Nkem Chukwueme chux anago Emperor Ubochioma Amarachi Okorie Odume Bethrand Nwafor Charles Abia State Ministry of Health Umuahia Nigeria Department of Pharmacology Abia State University Okigwe Nigeria Institute of Human Virology Abuja Nigeria Challenge KNCV Abuja Nigeria Clinton Health Access Initiative Abuja Nigeria National Tuberculosis and Leprosy Control Program Abuja Nigeria School of Midwifery Umuahia Nigeria Department of Family Medicine National Hospital Abuja Nigeria German Leprosy and Tuberculosis Relief Association Enugu Nigeria

Tuberculosis (TB), diabetes mellitus and HIV co-morbidity is a rare and interrelated health condition with associated high morbidity and mortality especially in developing countries with high prevalence of TB. It has become an emerging concern to epidemiologists and TB control programs due to complexities in its control and management. Managing MDR-TB, DM and HIV comorbidity is challenging, with risk of unfavorable outcome;consequently, close monitoring is necessary. Individuals with weak immunity resulting from diseases such as uncontrolled Diabetes Mellitus (DM) and HIV have a higher risk of developing TB or progression from latent to active TB. We present a 65-year old known diabetic patient who presented to Royal Cross Hospital Ugwueke Abia State, Nigeria with a one-year history of recurrent productive cough with associated night sweats, low grade fever and marked weight loss. A diagnosis of drug-resistant TB with DM/HIV co-morbidity was made and co-managed by experts from the respective clinics and the State TB control program. The patient was declared cured (7 months consecutive negative cultures each taken 30 days apart) after completing 20 months of conventional MDR-TB treatment. The patient showed remarkable clinical improvement including weight gain, good diabetic control and significant increase in CD4 (700 cells). Managing MDR-TB patients with diabetes and HIV is challenging, however, appropriate treatment, psychosocial support, adequate blood sugar control as well as monthly monitoring of patients with requisite investigations are vital in achieving good treatment outcome.

关键词： Co-Morbidity-Diabetes-Multi Drug Resistant TB and HIV

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