Community-based active tuberculosis case finding using a symptom-based screening tool in the Volta Region, Ghana: International Journal of Infectious Diseases

George Edward Ntow, Margaret Kweku, Enoch Aninagyei, Kwabena O. Duedu*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    2 Citations (SciVal)


    Background: Early tuberculosis case detection is important for early commencement of treatment to improve treatment outcomes and also to prevent community spread of the disease. However, there is a paucity of data in Ghana on the efficiency of the symptom-based screening tool (SBS tool) to detect Mycobacterium tuberculosis in the communities. Therefore, this study assessed the usefulness of the SBS tool for community-based active case finding in the Volta Region of Ghana. Methods and materials: This cross-sectional study used house-to-house and durbar screening approaches for active tuberculosis (TB) case searching from six communities, three each from the Ketu South (high TB risk) and Akatsi North (low TB risk) districts in the Volta Region of Ghana. Random eligible participants were screened with the SBS tool to identify presumptive TB cases. One sputum sample was collected from each person with presumptive TB for detection of M. tuberculosis by the GeneXpert real-time technique. Results: A total of 1,025 people were screened from a population of 40,462, from which 332 (32.4%) were presumed to have M. tuberculosis infection. Of the 332 presumptive TB cases, 63.9% were obtained through house-to-house screening, while 36.1% were obtained through community durbar screening. Six M. tuberculosis-positive cases (with one rifampicin resistance) were detected by house-to-house screening but not from community durbar samples, yielding an overall prevalence of 15 per 100,000 population. Among TB symptoms screened and analysed, association existed only between night sweat and TB case detection (chi(2) = 3.9, P = 0.049). Conclusion: Although cumbersome and capital intensive, community-based active case searching through house-to-house screening using the SBS tool proved effective in detecting M. tuberculosis in the communities. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
    Original languageEnglish
    Pages (from-to)56-62
    Number of pages7
    JournalInternational Journal of Infectious Diseases
    Publication statusPublished (VoR) - Jan 2021


    The authors acknowledge the tremendous efforts of the community-based surveillance volunteers who assisted in case identification and screening procedures. The laboratory staff of the Ketu South Municipal Health Directorate are acknowledged for their support in sputum examination. We offer special thanks to the health care directors of the two districts in which this study was conducted for granting permission for the study to be conducted in their districts. We also thank the chiefs of selected communities who allowed the study to be conducted in their communities.

    FundersFunder number
    Ketu South Municipal Health


      • Community active case search
      • Community TB screening
      • Durbar
      • House-to-house Screening
      • Tuberculosis
      • Volta Region


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