Assigning focal persons to notify more tuberculosis patients: lessons learned in southern Ethiopia

Setting: Health centres in Southern Ethiopia. Objective: To determine factors contributing to the large variations in the notification of smear-positive tuberculosis (TB) cases. Design: A cross-sectional study in selected health centres from areas with high and low case notification was conducted and health system and health care worker (HCW) related determinants were examined. Results: A total of 50 (61.0%) health centres and 172 (65.2%) HCWs from high case notification areas, and 32 (39.0%) health centres and 92 (33.8%) HCWs from low case notification areas were included in the study. Assignment of a full-time TB focal person at the TB clinic (adjusted odds ratio [aOR] 5.8, 95%CI 1.5–22.4) and availability of TB recording tools (aOR 7.0, 95%CI 1.5–32.5) were independent predictors of high case notification rates. HCW knowledge about TB screening, diagnosis and treatment was positively associated with case notification (aOR 2.53, 95%CI 1.42–4.48). Conclusion: Increased TB case notification was associated with the presence of a full-time focal person, availability of TB recording tools and good knowledge about TB among HCWs. Putting in place these measures in all health centres could increase TB notification in the region.