OA-68 Implementation of integrated health-checks for TB-affected households in Zimbabwe

Résumé fourni par la source

Background Tuberculosis (TB)-affected communities are often highly vulnerable, with social, economic, and biological factors increasing risk of TB and other chronic conditions, whilst impeding healthcare access. Traditional approaches to TB contact tracing do not address non-TB related health needs. Methods Nested in an EDCTP-funded TB household contact (HHC) cohort (ERASE-TB), we invited HHC (aged ≥10 years) and people with TB (aged ≥18 years, at treatment completion) to participate in a health-check. The health-check was collaboratively developed and, in addition to TB, included conditions which have high local prevalence (e.g. HIV, hypertension), are associated with TB (e.g. undernutrition, diabetes, mental health, alcohol and smoking), or were of importance to the community (e.g. vision). Testing was performed using point-of-care tools. Participants with a positive result were referred; linkage to care was assessed. The health-check component was funded by Wellcome Trust. Results From 197 households, 482 HHC and 60 people with TB participated in the health-check. Reasons for non-attendance among people with TB included having moved away, death and not having time. 62% HHC and 32% people with TB were women. 2.4% people reported currently/recently taking TB preventative therapy. Overall, 15% HHC and 31% people with TB were living with HIV, of whom 9% were diagnosed through screening. Six percent of HHC and 27% people with TB were underweight; 22% HHC and 12% people with TB had hypertension; 3% HHC and 13% people with TB had diabetes; 31% HHC and 41% people with TB had mental health symptoms; 15% HHC and 19% people with TB had visual impairment. Most chronic conditions were previously undiagnosed. Successful linkage to care varied by condition. Conclusion Members of TB-affected households experience a high burden of chronic conditions. Inclusion of strategies to identify and address these factors within TB screening may reduce TB incidence and improve health.

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