Factors Contributing to Low Tuberculosis Case Detection in BAWKU West District in The Upper East Region of Ghana

ABSTRACT Introduction Tuberculosis remains a major public health concern affecting one-third of the world’s population despite numerous interventions put in place to curb its occurrence by the national TB control programme. Early case detection and prompt treatment cures the patient’s breaks the transmission chain and improves the effort of control. The aim of this study was to determine the factors contributing to low TB case detection in Bawku west District in the Upper East Region. Method: A cross-sectional study design involving quantitive method was conducted on 166 community members, 13 health workers involving in TB activities in the hospital and subdistricts, five laboratory staff, 159 community-based health surveillance volunteers as well as 2,581 records was reviewed from January to December 2017. A structured questionnaire was used to collect data from the participants. Result: Only 377 out of 2,581 suspected TB clients who were referred for sputum smear microscopy availed themselves for the test. Out of which 10.6% (40/377) tested positive for sputum smear microscopy for TB. Knowledge of community based surveillance volunteers about tuberculosis caused by germs was universal (94.2%, 149/158) and about 80% (125/158) of the surveillance volunteers knew that tuberculosis is transmitted by droplets released through coughing and sneezing. Lack of refresher training of community-based surveillance volunteers and poor support for them were predictors of referral of suspected TB clients to health facility. Poor management of data by health staff also affected low TB case detection. Close to 60% (59.2%, 97/164) indicated an intention to seek care first in the health facility when they have symptoms of tuberculosis. Finally, poor contact tracing of suspected cases also influences case detection negatively. xiv Conclusion: Lack of training of community-based surveillance volunteers on TB case detection and poor Support for them hinders the referral of suspected TB case to a health facility. Community members intention to seek care in health facility and poor data management were some of the factors contributing to low TB case detection in Bawku West District in the Upper East Region of Ghana.