Finding missing TB cases in Northern Nigeria

SETTING: Despite recent progress in TB notification rates, 6.2% of the 3.1 million 'missing' people with TB globally are from Nigeria. Identifying these 'missing' cases will improve TB control efforts in Nigeria. OBJECTIVE: This paper aims to describe the outcome of an intensified TB case-finding strategy in northern Nigeria. DESIGN: An intensified TB case-finding strategy was implemented in four states in northern Nigeria from October 2021 to September 2022. Trained ad-hoc staff screened hospital attendees and linked identified persons with presumptive TB to diagnosis using a hub and spoke approach. People with confirmed TB were linked to treatment. Contributions of the strategy to the national TB notification rates for each state were assessed. RESULTS: A total of 1.17 million individuals were screened for TB across the four project States. 64,079 people with presumptive TB were identified, of which 10.1% were diagnosed with TB and 97% of those diagnosed were placed on treatment. Averagely, 33.3% of the TB cases notified from each state were contributions from the hospital-based Intensified TB case-finding intervention. CONCLUSION: Facility-based intensified TB case-finding results in significant improvement in TB notification rates and a good strategy to improve the identification of missing TB cases in Nigeria.