# Finding missing TB cases in Northern Nigeria

## TL;DR

This study shows that a targeted TB screening program in northern Nigeria successfully identified many previously undiagnosed TB cases.

## Contribution

The study demonstrates the effectiveness of a hospital-based intensified TB case-finding strategy in identifying missing TB cases in Nigeria.

## Key findings

- 1.17 million individuals were screened, identifying 64,079 presumptive TB cases.
- 10.1% of presumptive TB cases were confirmed, with 97% linked to treatment.
- The intervention contributed 33.3% of TB notifications in each state.

## Abstract

Despite recent progress in TB notification rates, 6.2% of the 3.1 million ‘missing’ people with TB globally are from Nigeria. Identifying these ‘missing’ cases will improve TB control efforts in Nigeria.

This paper aims to describe the outcome of an intensified TB case-finding strategy in northern Nigeria.

An intensified TB case-finding strategy was implemented in four states in northern Nigeria from October 2021 to September 2022. Trained ad-hoc staff screened hospital attendees and linked identified persons with presumptive TB to diagnosis using a hub and spoke approach. People with confirmed TB were linked to treatment. Contributions of the strategy to the national TB notification rates for each state were assessed.

A total of 1.17 million individuals were screened for TB across the four project States. 64,079 people with presumptive TB were identified, of which 10.1% were diagnosed with TB and 97% of those diagnosed were placed on treatment. Averagely, 33.3% of the TB cases notified from each state were contributions from the hospital-based Intensified TB case-finding intervention.

Facility-based intensified TB case-finding results in significant improvement in TB notification rates and a good strategy to improve the identification of missing TB cases in Nigeria.