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Open Access Assessment of TB underreporting by level of reporting system in Lagos, Nigeria

BACKGROUND: Nigeria has an estimated TB prevalence of 219 per 100,000 population. In 2019, Nigeria diagnosed and notified 27% of the WHO-estimated cases of all forms of TB and contributed 11% of the missing TB cases globally.

OBJECTIVE: To assess TB underreporting by type and level of health facility (HF), and associated factors in Lagos State, Nigeria.

METHODOLOGY: Quantitative secondary data analysis of TB cases was conducted in 2015. χ2 test was used to assess the association between treatment initiation, TB underreporting, local government area (LGA) and HF characteristics.

RESULTS: Overall, 2,064 persons with bacteriologically confirmed TB (15.5%) were not matched to patients in sampled TB registers. Treatment status was unknown for 86 cases (IQR 55–97) per LGA. LGAs with higher case-loads had higher proportions of cases with unknown TB status. Discrepant reporting of treated TB was also common (60% HFs). Primary-level TB treatment facilities and unengaged private facilities were less likely to notify.

CONCLUSION: There was TB under-reporting across all types and levels of HFs and LGAs. There is a need to revise or strengthen the process of supervision and data quality assurance system at all levels

Keywords: Nigeria; TB reporting system; TB underreporting; inventory study

Document Type: Research Article

Affiliations: 1: KNCV Tuberculosis Foundation, The Hague, Netherlands 2: Department of Public Health, Institute for Tropical Medicine, Antwerp, Belgium 3: Mainland Hospital, Yaba, Lagos, Nigeria 4: National TB & Leprosy Control Program, Abuja, Nigeria 5: New York Medical College, NY, New York 6: Health Research Unit, Lagos State Ministry of Health, Lagos, Nigeria 7: Lagos State TB and Leprosy Control Program, Lagos State Ministry of Health, Lagos, Nigeria 8: Walden University, Minneapolis, MN, USA

Publication date: September 21, 2022

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