Strengthening contact tracing capacity of pulmonary tuberculosis patients in Enugu, southeast Nigeria: a targeted and focused health education intervention study

BACKGROUND: Nigeria ranks 10 out of the 22 countries in the world with the highest TB burden. Contact tracing enhances case finding and increases the probability of cure. The purpose of the study is to improve the contact tracing skills of tuberculosis patients at the major TB centre in Enugu State, Nigeria. METHODS: The study is an educational intervention with a study and a control groups selected using multi-stage sampling techniques. A calculated sample size of 190 patients was used for each group. The instrument was a pre-tested semi-structured interviewer administered questionnaire. Data entry and analysis was done using Epi-info version 3.3.2. Chi-square test and student t –test were used at p < 0.05 level of significance and 95 percent confidence interval. RESULTS: Awareness of contact tracing at baseline and post intervention were respectively 18.2% and 85.2% (X(2) = 158.4, DF = 1, p = 0.000; CI: 15.8-82.2) for the study group; 18.4% and 26.0% (X(2) = 3.31, DF = 1, p = 0.069; CI: -9.9-24.7) for the control group. Knowledge that contact tracing involve bringing all household contacts of TB patients for screening was 79 (44.9%) and 33 (19.2%) for the study and control groups at baseline (X(2) = 26.32, p = 0.000; CI: 7.2-44.1), but 151 (85.8%) and 36(20.9%) for the same at post-intervention (X(2) = 147.22, p = 0.000; CI: 49.3-80.1). At baseline, only 5 (2.8%) of the study and 6(3.5%) of the control groups ( X(2) = 0.12, p = 0.730; CI: -14.2-12.8 ) brought two or more contacts for screening. At post-intervention, the figure rose to 114 (64.8%) and 9 (5.2%) (X(2) = 134.94, p = 0.000; CI: 44.3-74.9) for the study and control groups respectively. Over 50% of the contacts brought for screening were less than 10 years; 31 (18.3%) at baseline to 138 (81.7%) post-intervention in the study group (CI: 47.6-79.2), and 26 (35.1%) to 38 (51.4%) for the control group (X(2) = 12.472, p = 0.000; CI: 0.1 -32.5). CONCLUSION: Intensive planned health education intervention has been used to improve the contact tracing skills of the TB patients in a major TB centre in Enugu State, Nigeria. Further training and re-training of TB patients on contact tracing is highly recommended.