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Designing community-based strategies to reach non-household contacts of people with tuberculosis in Lusaka, Zambia

A rapid qualitative study among key stakeholders

Bibliographic Data

ID22084704
AuthorsAndrew D Kerkhoff (0000-0002-5023-6658, San Francisco General Hospital, corresponding author), Marksman Foloko (Centre for Infectious Disease Research in Zambia), Evelyn Kundu-Ng’andu (Centre for Infectious Disease Research in Zambia), Herbert Nyirenda (0000-0003-0359-9058, Centre for Infectious Disease Research in Zambia), Zainab Jabbie (0000-0002-7437-3323, Centre for Infectious Disease Research in Zambia), Mainza Syulikwa (Centre for Infectious Disease Research in Zambia), Clovis Mwamba (0000-0002-7626-6273, Centre for Infectious Disease Research in Zambia), Chanda Mwamba, Mary Kagujje (0000-0003-4818-6548, Centre for Infectious Disease Research in Zambia), Monde Muyoyeta (0000-0003-3609-5403, Centre for Infectious Disease Research in Zambia), Anjali Sharma (0000-0001-6297-3113, Centre for Infectious Disease Research in Zambia)
Year2025
Volume12
Pages1408213-1408213
Publication date2025-01-13
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1408213
PMID39872096
OpenAlexW4406346652
LanguageEN
References cited46

Background: In high-burden settings, most tuberculosis (TB) transmission likely occurs outside the home. Our qualitative study in Zambia explored the acceptability and preferences for designing TB active case finding (ACF) strategies to reach non-household contacts of people with TB. Methods: = 12) of community venue types identified as potential TB transmission locations. Interviews explored TB attitudes and beliefs, and perceptions toward two ACF strategies targeting non-household contacts: (1) "social-network strategy"-persons with newly diagnosed TB reach out to their close non-household contacts and (2) "venue-based strategy"-HCWs conduct screening at community venues frequented by persons with newly diagnosed TB. We used the Consolidated Framework for Implementation Research (CFIR) framework to develop interview topic guides and analyze data using a rapid deductive approach. Results: All participants felt that TB was an important issue in their community and that new detection strategies were needed. A "social-network strategy" was perceived as acceptable and feasible, where participants noted it was a caring act and could facilitate early diagnosis. For a "venue-based strategy," most participants suspected TB transmission occurred at bars/taverns due to heavy alcohol use and prolonged time spent in crowded spaces; churches and betting halls were also commonly mentioned locations. Nearly all owners/leaders and patrons/attendees of bars, churches, and betting halls expressed acceptance of a venue-based strategy. They also indicated an interest in participating, citing many benefits, including increased TB knowledge/awareness, early diagnosis, convenience, and possibly reduced transmission, and recommended that the strategy incorporate sensitization, consent, volunteerism, and respectful, confidential, private services. For both strategies, most participants preferred the use of and being approached by trained peer TB survivors to facilitate ACF, given their prior TB patient experience and trust among community members. Conclusion: Stakeholders found social-network and venue-based TB-ACF strategies highly acceptable, recognizing their potential benefits for individuals and the broader community. Future research should evaluate the feasibility and effectiveness of TB ACF strategies for reaching non-household contacts

Community health workers · Environmental health · Family medicine · Health services · Population · Qualitative research · Sociology · Tuberculosis · Healthcare Facilities Design and Sustainability · HIV/AIDS Research and Interventions · Medicine · Nursing · Tuberculosis Research and Epidemiology

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Citation velocityhistorical
Highly citedNo
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