Contribution of 'TB clubs' to tuberculosis control in a rural district in Ethiopia

SETTING: A rural district (Estie) in South Gender, Ethiopia. OBJECTIVE: TO describe the contribution of 'TB clubs' (small support groups of patients based on where they live) to the performance of the tuberculos is control programme in Estie District. DESIGN: A descriptive study of the formation of 'TB clubs', their contribut ion to case-finding and the treatment outcomes before and after formation o f the 'TB clubs'. RESULTS: The proportion of actual among expected attendances of tuberculosi s patients for follow-up during treatment at health facilities significantl y increased (P < 0.001) after the introduction of the TB clubs. Community e lders, community health agents and local health workers helped TB clubs to refer tuberculosis suspects, promote treatment adherence and trace defaulte rs as an integral part of a district tuberculosis programme. The TB clubs r eferred 181 tuberculosis suspects in the community for investigation, of wh om 65% subsequently had a diagnosis of tuberculosis. TB clubs identified 69 % of all patients and 76% of new sputum smear-positive pulmonary patients d iagnosed in the district. Treatment success rates in new sputum smear-posit ive, smear-negative and extra-pulmonary tuberculosis patients were 83%, 79% and 81%, respectively. CONCLUSION: The formation of TB clubs contributed to the effective implemen tation of a district tuberculosis programme. Further evaluation is needed t o assess the sustainability and applicability of the approach in other sett ings.