Evaluation of the Involvement of Community Health Workers in Adherence to Anti-Tuberculosis Treatment in Bangui, Central Africa Republic in 2024

Introduction In Central African Republic, the community approach plays a key role in the fight against tuberculosis. Our objective was to assess anti-tuberculosis treatment adherence, obstacles and facilitators to community monitoring of tuberculosis in Bangui.  Methodology We conducted an analytical cross-sectional study among patients treated for at least one month for tuberculosis at three sites in Bangui. A kobocollecte questionnaire was used to collect data that were analyzed using SPSS V25 software (risk α = 5%). The qualitative part based on individual and group interviews explored the obstacles and facilitators to communication between CHWs and tuberculosis patients. Data analysis was performed using NVIVO V14 software.  Results 262 patients with a mean age of 35.11±12.88 years were included; the sex ratio was 1.54. The frequency of poor compliance was 13.8%. In univariate analysis, the factors associated with poor compliance were lack of instruction and non- acceptance of home visits by community health workers (p=0.034 and p=0.040 respectively). Barriers to communication between CHWs and patients were fear of stigma, hunger, lack of information about CHWs, non-compliance with the specifications and poor working conditions. Facilitators included community distribution of anti-tuberculosis drugs, nutritional support, peer support and visual aids.  Conclusion The implementation of community engagement faces challenges requiring a combined approach, tailored to the needs of beneficiaries.