E-poster: Periodic performance review with patent medicine vendors-a fulcrum for improving TB case detection in the community: A case study of Nasarawa state, Nigeria.

Basil Uguge, Bethrand Odume, Daniel Egbule, Maxwell Onuoha, Oghenetejiro Akpomiemie, Adamu Tari and Useni Sani, KNCV Tuberculosis Foundation.

Background

Patent Medicine Vendors (PMVs) are the first point of care for a large proportion of patients with chronic cough. Though considered as informal health sector, PMVs play a key role in the Nigeria health care delivery especially among the rural poor. The objective of the study was to demonstrate the effect of periodic performance review with PMVs in increasing TB case finding.

Intervention or response

We identified and trained 120 PMVs across 10 local government areas (LGA) in collaboration with the State TB Program and the National Association Proprietary and Patent Medicine Dealers (NAPPMED). Bi-monthly review meetings coordinated by NAPPMED with technical support from KNCV were held in each LGA to appraise the performance of the PMVs. PMVs were rewarded based on presumptive TB clients successfully referred and TB cases diagnosed. We compared the contribution of PMVs in each quarter to the overall state report from quarter 1 to quarter 4, 2018.

Results

In Q1 (January–March), PMVs contributed 342 (4%) of the 9540 presumptivesTB and reported 25 (4%) of the 625 TB cases notified by the state. In Q2 (April–June), PMVs contribution increased to 637 (15%) of the 4194 presumptive TB reported and 42 (7%) of total 657 TB cases notified. By Q3 (July–September), contributions from PMVs rose to 956(16%) of the 6010 presumptive TB cases reported and 88 (15%) of 606 TB cases notified. By quarter 4 (October–December), PMVs contributed 1155 (19%) of the 6157 presumptive TB cases and 107 (16%) of 686 TB cases notified. The TB case yield from presumptives identified by PMVs was 9% while the yield from the total presumptives in the state largely from intra-health facility screening was 11%.

KNCV has been fighting TB since its establishment in 1903. Over the past 117 years, the organization has acquired indispensable knowledge and experience in the field of effective TB control, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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