Challenges of Tuberculosis Screening and Existing Gaps in Contact Investigations in Oyo and Osun States, Nigeria

Abstract

Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of TB screening and the existing gaps in Contact Investigation (CI). This descriptive qualitative study was conducted in 8 local government areas with high TB burdens in Oyo and Osun States, Nigeria. Twenty-four focus group discussions and 27 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents' ages ranged from 17-85 years with a mean of 42.08±14.9 years, and (4.0%) had a postgraduate degree. The unwillingness of the majority of TB contacts who tested negative for TB to be placed on TB preventive therapy because of the belief that only a sick person should take drugs and hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB were some of the existing gaps reported in TB contact investigations. The findings emphasize the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.