Factors Contributing to Low Tuberculosis Case Detection in West Akim Municipality of the Eastern Region of Ghana: A Community and Health Facility Based Study

Abstract

This research has a keen interest into assessing health and community related factors that contribute and influences low TB case detection rate in the West Akim Municipality of the Eastern region of Ghana. Data was collected from a target group of community members and health workers using a well-structured questionnaire. Data from the field was collected using Epi Info 7 and then, exported to Microsoft Excel and finally transferred to SPSS version 24 for the analysis. Some statistical techniques such as descriptive statistics, reliability of scale, t-test of independence, chi-square and analysis of variance was used to obtain results from the data analysis.

Community related factors that has been identified as possible contributors to low TB detection rate are as follows, the availability of alternative means of health care (traditional healers, prayer camps, and herbs to manage suspected cases of TB. This turns to keep people away from the health facilities. The long time (2 days) it takes for an individual to get tested and to receive his/her tested results (time of diagnostics). The high levels of experienced stigma associated with psychological distress on suspected people with TB and on friends and relatives living with TB patients. the low knowledge of TB among some reasonable number of community members. The study also identified the possible health related factors influencing low TB case detection rate such as, Low TB trained personals and low TB education during health talks in creating awareness that TB is preventable, curable and treatable and that suspected people with TB (cough for more than two weeks) should seek medical attention. Community health nurses not including TB screening as part of their home visitation program and low level of contact tracing could also contribute to the low case detection rate. The highly inadequate number Gene Xpert machines, DOT centres and laboratories for the diagnostics of TB.  The study also found that, TB stigma even existed among health care providers against suspected patients. This negatively influence the health seeking behavior among suspected patients.

This study became necessary to generate information for the Ghana national TB control Programme for appropriate remedial actions to be taken to forestall any catastrophe that may result from undetected and untreated TB cases in the West Akim municipality.

Keywords: Gene Xpert machines, DOT Centres, Stigmatization, Psychological Distress, TB screening, Low TB Case Detection.

DOI: 10.7176/JHMN/72-11

Publication date:March 31^st 2020