Back
 JTR  Vol.2 No.4 , December 2014
Intensive TB Case Finding in Unsafe Settings: Testing an Outreach Peer Education Intervention for Increased TB Case Detection among Displaced Populations and Host Communities in South-Kivu Province, Democratic Republic of Congo
Abstract: Introduction: The Democratic Republic of Congo (DRC) is one of the high-burden TB countries in the world. The most affected provinces were North and South Kivu where displacements of the population favor transmission of infections. Delays in diagnosis are often causes for excessive mortality among TB patients. Aim of the Study: The study aimed to test an intervention designed to increase detection of TB cases in internally displaced persons and their host communities in South Kivu province. Methods: The project used a quasi-experimental method, with prospective data collection every six months. Two peri-urban districts were selected and designated as intervention and control districts respectively. Twenty peer educators were selected among prospective TB suspects who sought care in health facilities. The peer educators were trained and encouraged to actively influence, identify and refer potential TB suspects to health centers. The data on new TB suspects seen and cases diagnosed in both districts were collected and compared over two and a half years period. Results: This pilot study has demonstrated that the intervention has had some positive effects on both the number of persons suspected with TB who were diagnosed using either microscopy or clinical assessment. Even in terms of case detection, the study demonstrated that the number of cases detected in the intervention district was at least twice the number of cases detected in the control district. Conclusion: Nonprofessional educators can influence TB case detection even in unstable settings, but their effectiveness is dependent on the security situation. National TB control programs need to adapt community mobilization strategies to local developments even in unsafe settings.
Cite this paper: Mukungo, S. , Kaboru, B. (2014) Intensive TB Case Finding in Unsafe Settings: Testing an Outreach Peer Education Intervention for Increased TB Case Detection among Displaced Populations and Host Communities in South-Kivu Province, Democratic Republic of Congo. Journal of Tuberculosis Research, 2, 160-167. doi: 10.4236/jtr.2014.24020.
References

[1]   Harvard Humanitarian Initiative (2010) “Now the World Is without Me”: An Investigation of Sexual Violence in Eastern Democratic Republic of Congo. A Report by the Harvard Humanitarian Initiative with Support from Oxfam America, Harvard Humanitarian Initiative & Oxfam International, Boston.

[2]   Grard, G., Biek, R., Tamfum, J.J., Fair, J., Wolfe, N., Formenty, P., Paweska, J. and Leroy, E. (2004) Emergence of Divergent Zaire Ebola virus Strains in Democratic Republic of the Congo in 2007 and 2008. Journal of Infectious Diseases, 11, S776-S784. http://doi.org/10.1093/infdis/jir364

[3]   Coghlan, B., Brennan, R.J., Ngoy, P., Dofara, D., Otto, B., Clements, M. and Stewart, T. (2006) Mortality in the Democratic Republic of Congo: A Nationwide Survey. The Lancet, 367, 44-51.
http://dx.doi.org/10.1016/S0140-6736(06)67923-3

[4]   Zarocostas, J. (2009) Some 45,000 People Die Each Month in Congo as Result of Collapsed Health Service, Says UN Official. BMJ, 338, b2652.

[5]   Van Herp, M., Parque, V., Rackley, E. and Ford, N. (2003) Mortality, Violence and Lack of Access to Healthcare in the Democratic Republic of Congo. Disasters, 27, 141-153.
http://dx.doi.org/10.1111/1467-7717.00225

[6]   Henegar, C., Behets, F., Vanden Driessche, K., Tabala, M., Bahati, E., Bola, V. and Van Rie, A. (2012) Mortality among Tuberculosis Patients in the Democratic Republic of Congo. International Journal Tuberculosis and Lung Diseases, 16, 1199-1204. ttp://dx.doi.org/10.5588/ijtld.11.0613

[7]   High-Level Forum on Health MDGs (2010) Health in Fragile States: An Overview Note. Paris, 14-15 November, accessed on 05 July 2010. http://www.hlfhealthmdgs.org/Documents/HealthFragileStates.pdf

[8]   Rieder, H. (1999) Epidemiologic Basis of Tuberculosis Control. International Union against Tuberculosis and Lung Disease, Paris.

[9]   Byamungu, D.C. and Ogbeiwi, O.I. (2003) Integrating Leprosy Control into General Health Service in a War Situation: The Level after 5 Years in Eastern Congo. Leprosy Review, 74, 68-78.

[10]   Rodger, A.J., Toole, M., Lalnuntluangi, B., Muana, V. and Deutschmann, P. (2002) DOTS-Based Tuberculosis Treatment and Control during Civil Conflict and an HIV Epidemic, Churachandpur District, India. Bulletin of the World Health Organization, 80, 451-456.

[11]   Self-Help in Eliminating Life-Threatening Diseases (2011) The Self-Help in Eliminating Life-threatening Diseases (SHIELD): A Start Kit. Center for Diseases Control (CDC). Accessed 10 November 2013.
http://effectiveinterventions.org/en/HighImpactPrevention/Interventions/SHIELD.aspx

[12]   Croft, L.A., Hayward, A.C. and Story, A. (2013) Tuberculosis Peer Educators: Personal Experiences of Working with Socially Excluded Communities in London. International Journal of Tuberculosis and Lung Disease, 17, 36-40. http://dx.doi.org/10.5588/ijtld.13.0309

[13]   Liu, Q., Liu, L., Vu, H., Liu, X., Tang, S. and Wang, H. (2013) Comparison between Peer-Led and Teacher-Led Education in Tuberculosis Prevention in Rural Middle Schools in Chongqing, China. Asia-Pacific Journal of Public Health, 4, 1-11. http://doi.org/10.1177/1010539513498767

[14]   McCue, M. and Afifi, L.A. (1996) Using Peer Helpers for Tuberculosis Prevention. Journal of American College Health, 44, 173-176. http://dx.doi.org/10.1080/07448481.1996.9937525

[15]   Management Sciences for Health (MSH) (2008) Democratic Republic of Congo (DRC) Primary Health Care Project in West/Central Congo: Assessment Report. Accessed on 15 August 2014.
http://pdf.usaid.gov/pdf_docs/PNADS456.pdf

 
 
Top