Pulmonary tuberculosis case detection in South Sudan

Abstract

Background: The National Tuberculosis (TB) Control Programme in South Sudan was created in 2006, and non-governmental organizations (NGOs) are its main implementers. Pulmonary tuberculosis (PTB) is a major public health threat. Available literature describes case finding as very low, but treatment success as high. This study was conducted to establish the true picture of case detection and to suggest ways to improve on case finding.

Methods: Recent trends in routine TB case notification as well as case detection and treatment outcome rates were analysed. Approaches and methods utilized in PTB case finding by the involved NGOs were examined. Opinions on how best to improve on case detection were generated.

Results: There was an increase in the trend of notification from 2002 to 2009, but the sputum smear-positive proportion was stable for the same period. The case detection rates were very low, all below 50% of expected for the given years; treatment success rates were high and stable, at an average of 80%; the defaulter rate was on the increase, especially after 2006. The NGOs seemed to be using the recommended approaches and methods to find and diagnose PTB. There was variation in opinions on how to improve on case detection in the region, with overlap in some instances.

Conclusions: PTB case detection has been very low in South Sudan over the last decade; however, the DOTS treatment success rate is high. The high treatment success rate could mean that if more PTB cases could be found in the communities, more are likely to be treated successfully.