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Applying integrated communication strategies to increase tuberculosis prevention knowledge and case identification capacities in West Coast District, Western Cape Province, South Africa

Publication date: 
Oct 2018

The World Health Organization (2017) estimated that South Africa had 154,000 missing tuberculosis cases and urged for intensified case-finding. Educating communities, and availing information about TB services in their areas is key. To translate knowledge into action, however, it is sometimes necessary to bring services to people, particularly in low socioeconomic contexts.

Cederberg Sub-District, Western Cape Province records TB incidence of 837/100,000. Based on 658 TB patient’s data, in 2016 the sub-district noted: 82% treatment success, 6% death, and 6% lost to follow-up rates.

Stakeholders received ‘Basic TB Management and Interpersonal Communication for Communities’ training prior to conducting community dialogues and door-to-door screening in Citrusdal and Clanwilliam.

Cross-promotion of messages on community radio and social media was done to (i) disseminate TB information, and (ii) promote community TB screening activities.  

Sixty-one stakeholders were trained, to increase knowledge and capacities to identify TB symptoms, refer individuals to health facilities, and speak about TB with others.  

770 people received individualised TB information verbally, and in pamphlets. Of these, 416 were screened for TB, with 66 presumptive cases identified. Thirty-one were tested at their local health facility. Two tested positive for TB and were initiated on appropriate treatment. One contact under five years-old was initiated on Isoniazid Preventive Therapy.

Two interviews were broadcast on a local community radio station with listenership of 40,000.

Information was shared with 2,226 Facebook and Twitter followers generating conversations; notably about inadequate knowledge surrounding TB diagnosis and treatment, and challenges adhering to treatment because of side effects.

Testing everyone with TB symptoms at home was not possible. Thirty-five people with symptoms declined to visit the health facility. Follow-up visits were scheduled for local health facility staff to test persons with symptoms at home. Communication aimed at reducing TB stigma in these communities will be prioritised.