Contribution of 'TB clubs' to tuberculosis control in a rural district in Ethiopia.

Abstract

SETTING: A rural district (Estie) in South Gonder, Ethiopia. OBJECTIVE: To describe the contribution of 'TB clubs' (small support groups of patients based on where they live) to the performance of the tuberculosis control programme in Estie District. DESIGN: A descriptive study of the formation of 'TB clubs', their contribution to case-finding and the treatment outcomes before and after formation of the 'TB clubs'. RESULTS: The proportion of actual among expected attendances of tuberculosis patients for follow-up during treatment at health facilities significantly increased (P < 0.001) after the introduction of the TB clubs. Community elders, community health agents and local health workers helped TB clubs to refer tuberculosis suspects, promote treatment adherence and trace defaulters as an integral part of a district tuberculosis programme. The TB clubs referred 181 tuberculosis suspects in the community for investigation, of whom 65% subsequently had a diagnosis of tuberculosis. TB clubs identified 69% of all patients and 76% of new sputum smear-positive pulmonary patients diagnosed in the district. Treatment success rates in new sputum smear-positive, smear-negative and extra-pulmonary tuberculosis patients were 83%, 79% and 81%, respectively. CONCLUSION: The formation of TB clubs contributed to the effective implementation of a district tuberculosis programme. Further evaluation is needed to assess the sustainability and applicability of the approach in other settings.