Irene Ane Anyangwe^1,, Henry Dilonga Meriki^{1, 2}, Damian Nota Anong¹, Chi Joseph Shu¹, Kukwah Anthony Tufon^{1, 3}, Fritz Roland Nsonghomanyi Fonkeng¹, Nkwain Victorine Nayah⁴, Kah Emmanuel Nji⁴, Theresa Nkuo-Akenji¹, Fidelis Chongwa⁵, Vincent PK Titanji⁶

Background: Tuberculosis (TB) remains a serious public health concern worldwide. The predominant global strategy for identifying people with TB is ‘passive case detection’ which has a low case detection rate therefore is an obstacle to the long-term success of TB control programs, giving the possibility of undiagnosed patients posing great risk of transmitting the infection to others. Methods: A hospital/community-based cross-sectional study was conducted on 921 clinically suspected consented TB patients and those confirmed by microscopy of Ziehl Neelsen stain for Acid fast bacilli (AFB) were contacted at their residence so as to identify any household contacts (HHC) with symptoms of TB. AFB Smear negative cases were further investigated using sodium hypochlorite (NaOCl) centrifuge-concentrated smears technique. Data was collected from participants and the results were summarized using descriptive statistics, bivariate and multivariate logistic regression analyses. Results: The prevalence of pulmonary TB was 20.6% (190/921) and 7.04% (5/71) among TB suspected cases and symptomatic HHC respectively. In a univariate analysis, age group (p = 0.011), marital status (p = 0.019), employment status (p = 0.041), previous TB contact (p < 0.001), HIV status (p = 0.001) and family size (p = 0.003) were associated with TB occurrence. However, only HIV status (AOR = 4.98, 95% CI = 1.73 - 14.34) and previous TB contact (AOR = 6.08 95% CI = 2.86-12.89) were independently associated with TB occurrence. Approximately 30% of the diagnosed TB cases were detected with sodium hypochlorite (NaOCl) centrifuge-concentrated smears. Conclusion: The study showed that, contact investigation can improve case detection rates for active tuberculosis and therefore can augment the existing comprehensive package of interventions that could substantially reduce at the population level TB disease burden. Risk factors such as family size > 5 persons, previous contact with TB patients, marital and HIV status were associated with TB prevalence. Concentration technique is more effective with a higher rate of detection compared to direct smear.

household contacts, bacteriologically confirmed tuberculosis, risks factors, sodium hypochlorite centrifuged-concentrated smear