The pilot implementation of Surveillance Outbreak Response Management and Analysis System (SORMAS) in improving tuberculosis case notification in Nigeria

Résumé fourni par la source

Nigeria is currently ranked sixth among eight countries that collectively account for two-thirds of global tuberculosis (TB) patients and the highest in Africa. The major challenges facing TB response in Nigeria are under-diagnoses and underreporting. The National Tuberculosis and Leprosy Control Program (NTBLCP) and the Nigerian Centre for Disease Control (NCDC) with support from the United States Agency for International Development (USAID) in collaboration with Knowledge Network for Disease Control and Vigilance, (KNCV Nigeria) and Institute of Human Virology Nigeria (IHVN) conducted a pilot study to determine the effectiveness of the use of a digital web-based surveillance platform- Surveillance Outbreak Response Management and Analysis System (SORMAS) for real-time TB reporting, case notification and management in selected non-DOTS facilities in Nigeria. One state in each of the six geo-political zones of the country was selected for the study. In each of the selected states, ten health facilities which were not providing DOTS services were selected using different criteria in the states. This was a pilot study and all consenting individuals who presented in the selected health facilities were screened for TB and data entered into the SORMAS platform irrespective of the presenting complaints of the individuals. The individuals considered as presumptive were referred to designated DOTS facilities for TB evaluation and the confirmed TB cases commenced treatment for TB at the designated DOTS facilities. The study lasted for one year. A total of 50,415 individuals presented at the selected health facilities during the study period. The median age was 27.0 years (IQR, 14–40 years) and majority of the clients, 55.4% were female. Less than half, 47.7% (24,052) were screened for tuberculosis and 16.3% (3910) were regarded as presumptive TB cases out of which 90.3%, (3531) were evaluated for TB. The TB yield among the presumptives was 4.4% giving a prevalence rate of 440/10,000 population. Children less than 5 years accounted for 3.2% of the diagnosed cases while those 55 years and above accounted for 22.3% of the diagnosed cases. A significantly higher proportion of males, 0.8% were diagnosed with tuberculosis when compared with the females, 0.5% ( p = 0.001). The Number Needed to Screen (NNS) for tuberculosis was significantly higher for the female respondents, (202) when compared with that for the males, 118 ( p < 0.001). Also, the Number Needed to Treat (NNT) for females (28) was significantly higher than that for males 19, ( p = 0.034), Similarly, a significantly higher proportion of clients who utilized public health facilities, 0.8% were diagnosed with TB when compared with those who utilized private health facilities, 0.6% ( p = 0.049). The yield from the SORMAS TB project revealed a high number of previously undetected TB cases. There is need to expand the reach of DOTS services in Nigeria as this will create more awareness for the disease among the people and also help in finding the missing TB cases. Greater attention should be paid to the elderly in matters related to TB case finding in Nigeria. Integrating SORMAS into TB service delivery in Nigeria will increase TB case notification and real time reporting thus aligning with Sustainable Development Goal 3, target 3.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.