Submission ID 130778
| Issue/Objective | In high TB burden settings, expanding screening coverage alone is insufficient without optimizing yield and efficiency. Programs must balance high-volume screening with targeted approaches that maximize case detection per effort invested. Under Nigeria's Global Fund GC7 implementation, community case finding (CCF) and private health facility (PHF) engagement were scaled nationally. This study evaluates the efficiency of both strategies using yield-focused metrics to inform resource prioritization. |
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| Methodology/Approach | We conducted a national retrospective analysis of routine TB program data from January to December 2025 across all 36 states and the Federal Capital Territory. Two platforms were assessed: community-based active case finding and private facility-based passive case detection. Indicators included screening volume, presumptive rate, diagnostic yield, and treatment linkage. Efficiency metrics-positivity rate and Number Needed to Screen (NNS)-were calculated to assess yield and resource use. Comparative analysis explored trade-offs between scale and efficiency. |
| Results | A total of 19.9 million individuals were screened. Private health facilities accounted for 12.6 million (63%), identifying 164,045 TB cases (positivity: 1.3%; NNS: 77). Community case finding screened 7.2 million (37%) and identified 195,221 cases (positivity: 2.7%; NNS: 37). Community screening was 2.1 times more efficient, with higher presumptive yield (37.2% vs. 15.8%) and stronger treatment linkage (95% vs. 85%). Despite lower efficiency, private facilities contributed 45.7% of total TB diagnoses due to higher throughput. |
| Discussion/Conclusion | Community case finding demonstrates superior efficiency, while private sector engagement ensures scale. A strategic hybrid model that integrates high-yield targeting with high-volume screening can optimize resource allocation and accelerate TB control. |
| Presenters and Affiliations | Joshua Odoma. G Institute Of Human Virology Nigeria Dr. Aderonke Agbaje Institute Of Human Virology Nigeria Dr. Olayemi Olupitan Institute Of Human Virology Nigeria Lucia Okwuonye Institute Of Human Virology Nigeria Fati-Murtala Ibrahim Institute of Human Virology Nigeria Chioma Ofoegbu Institute Of Human Virology Nigeria Pillatar Benjamin Institute of Human Virology Nigeria Hasiya Bello Institute of Human Virology Nigeria Dr Charles Mensah Institute Of Human Virology Nigeria Dr Patrick Dakum Institute Of Human Virology Nigeria |
