Outcome of Tuberculosis Case Surveillance at Kano Central Correctional Center, North-west Nigeria: A Need for Routine Active Case Findings for TB in Nigerian Correctional Centers
M. Tukur
KNCV Tuberculosis Foundation, Nigeria.
B. Odume *
KNCV Tuberculosis Foundation, Nigeria.
M. Bajehson
KNCV Tuberculosis Foundation, Nigeria.
C. Dimpka
KNCV Tuberculosis Foundation, Nigeria.
S. Useni
KNCV Tuberculosis Foundation, Nigeria.
C. Ogbudebe
KNCV Tuberculosis Foundation, Nigeria.
O. Chukwuogo
KNCV Tuberculosis Foundation, Nigeria.
N. Nwokoye
KNCV Tuberculosis Foundation, Nigeria.
C. Dim
University of Nigeria Teaching Hospital/ College of Medicine, Enugu Campus, Nigeria.
D. Nongo
Office of HIV/AIDS and TB, USAID Nigeria.
R. Eneogu
Office of HIV/AIDS and TB, USAID Nigeria.
T. Odusote
Office of HIV/AIDS and TB, USAID Nigeria.
O. Oyelaran
Office of HIV/AIDS and TB, USAID Nigeria.
I. Umar
Kano State TB, Leprosy and Buruli Ulcer Control Program, Ministry of Health Kano State, Nigeria.
C. Anyaike
National TB, Leprosy and Buruli Ulcer Control Program, Ministry of Health, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aim: To demonstrate the need for routine active TB case finding in Nigerian correctional centers through a TB case surveillance intervention at the largest correctional centre in the most populous state in Nigeria by KNCV Tuberculosis Foundation Nigeria.
Study Design: It was a retrospective review of public health intervention data derived from the mass TB screening of Kano central correctional centre inmates in Kano state, Nigeria. Methodology: A digital X-ray with artificial intelligence (AI) was used for mass TB screening of 1,967 consenting inmates at the Kano central correctional centre in Kano state, Nigeria, from 21st September to 2nd October 2020. Participants with CAD4TB score ≥ 60 had a GeneXpert assessment of their sputa for TB diagnosis. Where sputum production was not possible, or GeneXpert result was negative, expert clinical evaluation of the presumptive radiogram was carried out by experienced radiologist. Data from the project were extracted and analysed for this report. Proportions and means were compared with Fisher Exact test and Student t-test, respectively. A p-value of < 0.05 was considered statistically significant.
Results: Overall, 1,967 inmates were screened for TB and 92 (4.7%) presumptive were identified - males (4.8%, 91/92), females (1.9%, 1/92). Out of the 92 presumptive, 21 males were diagnosed as TB cases giving a TB prevalence of 1.1% among the inmates and 22.8% among presumptive. One of the TB cases had multi-drug resistant TB. The number needed to screen (NNS) was 94. All TB cases were enrolled in treatment.
Conclusion: The prevalence of TB at the Kano central correctional centre during the mass TB screening project was high. The National Tuberculosis Control Programme of Nigeria should accelerate the planned paradigm shift from passive to active case-finding for TB in Nigerian correctional centers.
Keywords: Mass Screening for TB, wellness on wheels truck, chest x-ray, CAD4TB, GeneXpert.