<i>FAST</i> Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment

Useni Sani; Gidado Mustapha; Onazi Jumoke; Eneogu Rupert; Chukwueme Nkemdilim; Ubochioma Emperor; Akang Gabriel; Obot Valerie; Omoniyi Amos

doi:doi:10.11648/j.sjph.20160404.23

FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment

Useni Sani, Gidado Mustapha, Onazi Jumoke, Eneogu Rupert, Chukwueme Nkemdilim, Ubochioma Emperor, Akang Gabriel, Obot Valerie, Omoniyi Amos

Published in Science Journal of Public Health (Volume 4, Issue 4)

Received: 1 March 2016 Accepted: 18 March 2016 Published: 28 July 2016

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Abstract

FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most public and some private health institutions are overcrowded with long waiting times to access health care services. This has led to an increasing importance to ensure effective TB prevention and control especially in settings were Presumptive TB cases, confirmed TB cases and People living with HIV (PLHIV) are seen. This study is aimed at describing the process of FAST implementation and its effect on reduction of time to diagnosis of TB and enrolment for care at tertiary Health care facilities. A prospective study in 12 facilities of 6 states with high TB and HIV burden; adapted guidelines, standard operating procedures (SOPs) and training materials for FAST strategy; trained pool of facilitators; field tested tools; advocacy visits to health facilities; collected base line data that preceded facility level sensitization of FAST implementation. Diagnosis of TB and DR-TB was in line with the national guidelines with the use of Acid Fast Bacilli (AFB) light microscopy and GeneXpert MTB/RIF technology. Follow-up evaluations were conducted monthly by State Tuberculosis and Leprosy Control Program (STBLCP) and quarterly by National TBL Control Program (NTBLCP). Data was analyzed using Stata 13 version 1 for paired t-test (mean comparison test). Average time to diagnosis of susceptible TB using 3 sputa samples reduced from a baseline of 2.9 days in April 2014 to 1.9 days by end of September 2014. Time to treatment of susceptible TB cases diagnosed either by AFB microscopy or Xpert reduced from a baseline of 3.9 days to 1.1 days. Similarly, average time for DR-TB cases diagnosed (including patients receiving their results) reduced from 2.3 days to 1 day. Proportion of TB cases diagnosed and started on treatment increased by up to 14-56% range among different facilities. Integrating FAST into health care delivery improves early diagnosis and enrolment to care at minimal cost; facilitate TB infection control in clinic waiting areas especially in low income countries like Nigeria. FAST also has additional advantage of increasing TB case notification.

Published in	Science Journal of Public Health (Volume 4, Issue 4)
DOI	10.11648/j.sjph.20160404.23
Page(s)	352-358
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

TB Infection Control, Intensified Case Finding, Health System Delay

References

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[19]	Güneylioglu D, Yilmaz A, Bilgin S, Bayram U, Akkaya E. Factors affecting delays in diagnosis and treatment of pulmonary tuberculosis in a tertiary care hospital in Istanbul, Turkey. Med Sci Monit. 2004 Feb; 10 (2): CR62-7.
[20]	Nardell E. and Dharmadhikari A. Turning off the spigot: reducing drug-resistant tuberculosis transmission in resource-limited settings. Int J Tuberc Lung Dis. Oct 2010; 14 (10): 1233–1243.
[21]	Reid M. J, Saito S, Nash D, Scardigli A, Casalini C, Howard A. A. implementation of tuberculosis infection control measures at HIV care and treatment sites in sub-Saharan Africa. Int J Tuberc Lung Dis. 2012 Dec; 16 (12): 1605-12. doi: 10.5588/ijtld.12.0033
[22]	Finnie RK, Khoza LB, van den Borne B, Mabunda T, Abotchie P, Mullen PD: Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub-Saharan African countries with high burdens of TB and HIV. Trop Med Int Health 2011, 16 (4): 394-411.
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APA Style

Useni Sani, Gidado Mustapha, Onazi Jumoke, Eneogu Rupert, Chukwueme Nkemdilim, et al. (2016). FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment. Science Journal of Public Health, 4(4), 352-358. https://doi.org/10.11648/j.sjph.20160404.23

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ACS Style

Useni Sani; Gidado Mustapha; Onazi Jumoke; Eneogu Rupert; Chukwueme Nkemdilim, et al. FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment. Sci. J. Public Health 2016, 4(4), 352-358. doi: 10.11648/j.sjph.20160404.23

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AMA Style

Useni Sani, Gidado Mustapha, Onazi Jumoke, Eneogu Rupert, Chukwueme Nkemdilim, et al. FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment. Sci J Public Health. 2016;4(4):352-358. doi: 10.11648/j.sjph.20160404.23

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@article{10.11648/j.sjph.20160404.23,
  author = {Useni Sani and Gidado Mustapha and Onazi Jumoke and Eneogu Rupert and Chukwueme Nkemdilim and Ubochioma Emperor and Akang Gabriel and Obot Valerie and Omoniyi Amos},
  title = {FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment},
  journal = {Science Journal of Public Health},
  volume = {4},
  number = {4},
  pages = {352-358},
  doi = {10.11648/j.sjph.20160404.23},
  url = {https://doi.org/10.11648/j.sjph.20160404.23},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20160404.23},
  abstract = {FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most public and some private health institutions are overcrowded with long waiting times to access health care services. This has led to an increasing importance to ensure effective TB prevention and control especially in settings were Presumptive TB cases, confirmed TB cases and People living with HIV (PLHIV) are seen. This study is aimed at describing the process of FAST implementation and its effect on reduction of time to diagnosis of TB and enrolment for care at tertiary Health care facilities. A prospective study in 12 facilities of 6 states with high TB and HIV burden; adapted guidelines, standard operating procedures (SOPs) and training materials for FAST strategy; trained pool of facilitators; field tested tools; advocacy visits to health facilities; collected base line data that preceded facility level sensitization of FAST implementation. Diagnosis of TB and DR-TB was in line with the national guidelines with the use of Acid Fast Bacilli (AFB) light microscopy and GeneXpert MTB/RIF technology. Follow-up evaluations were conducted monthly by State Tuberculosis and Leprosy Control Program (STBLCP) and quarterly by National TBL Control Program (NTBLCP). Data was analyzed using Stata 13 version 1 for paired t-test (mean comparison test). Average time to diagnosis of susceptible TB using 3 sputa samples reduced from a baseline of 2.9 days in April 2014 to 1.9 days by end of September 2014. Time to treatment of susceptible TB cases diagnosed either by AFB microscopy or Xpert reduced from a baseline of 3.9 days to 1.1 days. Similarly, average time for DR-TB cases diagnosed (including patients receiving their results) reduced from 2.3 days to 1 day. Proportion of TB cases diagnosed and started on treatment increased by up to 14-56% range among different facilities. Integrating FAST into health care delivery improves early diagnosis and enrolment to care at minimal cost; facilitate TB infection control in clinic waiting areas especially in low income countries like Nigeria. FAST also has additional advantage of increasing TB case notification.},
 year = {2016}
}

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TY  - JOUR
T1  - FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment
AU  - Useni Sani
AU  - Gidado Mustapha
AU  - Onazi Jumoke
AU  - Eneogu Rupert
AU  - Chukwueme Nkemdilim
AU  - Ubochioma Emperor
AU  - Akang Gabriel
AU  - Obot Valerie
AU  - Omoniyi Amos
Y1  - 2016/07/28
PY  - 2016
N1  - https://doi.org/10.11648/j.sjph.20160404.23
DO  - 10.11648/j.sjph.20160404.23
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 352
EP  - 358
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20160404.23
AB  - FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most public and some private health institutions are overcrowded with long waiting times to access health care services. This has led to an increasing importance to ensure effective TB prevention and control especially in settings were Presumptive TB cases, confirmed TB cases and People living with HIV (PLHIV) are seen. This study is aimed at describing the process of FAST implementation and its effect on reduction of time to diagnosis of TB and enrolment for care at tertiary Health care facilities. A prospective study in 12 facilities of 6 states with high TB and HIV burden; adapted guidelines, standard operating procedures (SOPs) and training materials for FAST strategy; trained pool of facilitators; field tested tools; advocacy visits to health facilities; collected base line data that preceded facility level sensitization of FAST implementation. Diagnosis of TB and DR-TB was in line with the national guidelines with the use of Acid Fast Bacilli (AFB) light microscopy and GeneXpert MTB/RIF technology. Follow-up evaluations were conducted monthly by State Tuberculosis and Leprosy Control Program (STBLCP) and quarterly by National TBL Control Program (NTBLCP). Data was analyzed using Stata 13 version 1 for paired t-test (mean comparison test). Average time to diagnosis of susceptible TB using 3 sputa samples reduced from a baseline of 2.9 days in April 2014 to 1.9 days by end of September 2014. Time to treatment of susceptible TB cases diagnosed either by AFB microscopy or Xpert reduced from a baseline of 3.9 days to 1.1 days. Similarly, average time for DR-TB cases diagnosed (including patients receiving their results) reduced from 2.3 days to 1 day. Proportion of TB cases diagnosed and started on treatment increased by up to 14-56% range among different facilities. Integrating FAST into health care delivery improves early diagnosis and enrolment to care at minimal cost; facilitate TB infection control in clinic waiting areas especially in low income countries like Nigeria. FAST also has additional advantage of increasing TB case notification.
VL  - 4
IS  - 4
ER  -

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Author Information

Useni Sani

KNCV Tuberculosis Foundation, Abuja, Nigeria
Gidado Mustapha

KNCV Tuberculosis Foundation, Abuja, Nigeria
Onazi Jumoke

KNCV Tuberculosis Foundation, Abuja, Nigeria
Eneogu Rupert

KNCV Tuberculosis Foundation, Abuja, Nigeria
Chukwueme Nkemdilim

KNCV Tuberculosis Foundation, Abuja, Nigeria
Ubochioma Emperor

National Tuberculosis and Leprosy Control Program, Federal Ministry of Health, Abuja, Nigeria
Akang Gabriel

National Tuberculosis and Leprosy Control Program, Federal Ministry of Health, Abuja, Nigeria
Obot Valerie

Akwa Ibom State Tuberculosis and Leprosy Control Program, Akwa Ibom State Ministry of Health, Uyo, Nigeria
Omoniyi Amos

World Health Organization, Abuja, Nigeria

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APA Style

Useni Sani, Gidado Mustapha, Onazi Jumoke, Eneogu Rupert, Chukwueme Nkemdilim, et al. (2016). FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment. Science Journal of Public Health, 4(4), 352-358. https://doi.org/10.11648/j.sjph.20160404.23

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ACS Style

Useni Sani; Gidado Mustapha; Onazi Jumoke; Eneogu Rupert; Chukwueme Nkemdilim, et al. FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment. Sci. J. Public Health 2016, 4(4), 352-358. doi: 10.11648/j.sjph.20160404.23

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AMA Style

Useni Sani, Gidado Mustapha, Onazi Jumoke, Eneogu Rupert, Chukwueme Nkemdilim, et al. FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment. Sci J Public Health. 2016;4(4):352-358. doi: 10.11648/j.sjph.20160404.23

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@article{10.11648/j.sjph.20160404.23,
  author = {Useni Sani and Gidado Mustapha and Onazi Jumoke and Eneogu Rupert and Chukwueme Nkemdilim and Ubochioma Emperor and Akang Gabriel and Obot Valerie and Omoniyi Amos},
  title = {FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment},
  journal = {Science Journal of Public Health},
  volume = {4},
  number = {4},
  pages = {352-358},
  doi = {10.11648/j.sjph.20160404.23},
  url = {https://doi.org/10.11648/j.sjph.20160404.23},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20160404.23},
  abstract = {FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most public and some private health institutions are overcrowded with long waiting times to access health care services. This has led to an increasing importance to ensure effective TB prevention and control especially in settings were Presumptive TB cases, confirmed TB cases and People living with HIV (PLHIV) are seen. This study is aimed at describing the process of FAST implementation and its effect on reduction of time to diagnosis of TB and enrolment for care at tertiary Health care facilities. A prospective study in 12 facilities of 6 states with high TB and HIV burden; adapted guidelines, standard operating procedures (SOPs) and training materials for FAST strategy; trained pool of facilitators; field tested tools; advocacy visits to health facilities; collected base line data that preceded facility level sensitization of FAST implementation. Diagnosis of TB and DR-TB was in line with the national guidelines with the use of Acid Fast Bacilli (AFB) light microscopy and GeneXpert MTB/RIF technology. Follow-up evaluations were conducted monthly by State Tuberculosis and Leprosy Control Program (STBLCP) and quarterly by National TBL Control Program (NTBLCP). Data was analyzed using Stata 13 version 1 for paired t-test (mean comparison test). Average time to diagnosis of susceptible TB using 3 sputa samples reduced from a baseline of 2.9 days in April 2014 to 1.9 days by end of September 2014. Time to treatment of susceptible TB cases diagnosed either by AFB microscopy or Xpert reduced from a baseline of 3.9 days to 1.1 days. Similarly, average time for DR-TB cases diagnosed (including patients receiving their results) reduced from 2.3 days to 1 day. Proportion of TB cases diagnosed and started on treatment increased by up to 14-56% range among different facilities. Integrating FAST into health care delivery improves early diagnosis and enrolment to care at minimal cost; facilitate TB infection control in clinic waiting areas especially in low income countries like Nigeria. FAST also has additional advantage of increasing TB case notification.},
 year = {2016}
}

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TY  - JOUR
T1  - FAST Strategy - A Sustainable Administrative TB Infection Control Measure in Nigeria: Reducing Time to TB Diagnosis and Enrolment to Treatment
AU  - Useni Sani
AU  - Gidado Mustapha
AU  - Onazi Jumoke
AU  - Eneogu Rupert
AU  - Chukwueme Nkemdilim
AU  - Ubochioma Emperor
AU  - Akang Gabriel
AU  - Obot Valerie
AU  - Omoniyi Amos
Y1  - 2016/07/28
PY  - 2016
N1  - https://doi.org/10.11648/j.sjph.20160404.23
DO  - 10.11648/j.sjph.20160404.23
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 352
EP  - 358
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20160404.23
AB  - FAST stands for Finding, Actively, Separating, and Treating. FAST focus health care workers on the most important administrative Tuberculosis (TB) transmission control intervention: effective TB treatment reduces TB spread rapidly, even before sputum smear and culture turn negative. General outpatient department (GOPD) and inpatient clinics in most public and some private health institutions are overcrowded with long waiting times to access health care services. This has led to an increasing importance to ensure effective TB prevention and control especially in settings were Presumptive TB cases, confirmed TB cases and People living with HIV (PLHIV) are seen. This study is aimed at describing the process of FAST implementation and its effect on reduction of time to diagnosis of TB and enrolment for care at tertiary Health care facilities. A prospective study in 12 facilities of 6 states with high TB and HIV burden; adapted guidelines, standard operating procedures (SOPs) and training materials for FAST strategy; trained pool of facilitators; field tested tools; advocacy visits to health facilities; collected base line data that preceded facility level sensitization of FAST implementation. Diagnosis of TB and DR-TB was in line with the national guidelines with the use of Acid Fast Bacilli (AFB) light microscopy and GeneXpert MTB/RIF technology. Follow-up evaluations were conducted monthly by State Tuberculosis and Leprosy Control Program (STBLCP) and quarterly by National TBL Control Program (NTBLCP). Data was analyzed using Stata 13 version 1 for paired t-test (mean comparison test). Average time to diagnosis of susceptible TB using 3 sputa samples reduced from a baseline of 2.9 days in April 2014 to 1.9 days by end of September 2014. Time to treatment of susceptible TB cases diagnosed either by AFB microscopy or Xpert reduced from a baseline of 3.9 days to 1.1 days. Similarly, average time for DR-TB cases diagnosed (including patients receiving their results) reduced from 2.3 days to 1 day. Proportion of TB cases diagnosed and started on treatment increased by up to 14-56% range among different facilities. Integrating FAST into health care delivery improves early diagnosis and enrolment to care at minimal cost; facilitate TB infection control in clinic waiting areas especially in low income countries like Nigeria. FAST also has additional advantage of increasing TB case notification.
VL  - 4
IS  - 4
ER  -

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