The World Health Organization recommends use of Xpert® MTB/RIF (Xpert®) as a first-line TB diagnostic test. By 2018 there were 183 machines in Kenya in public hospitals across the country. However, despite the availability of these testing kits and efforts by the National TB Programme to provide training and guidelines; under detection of TB in children and underuse of TB diagnostic tests in Kenya is still quite high. For example, 75% of TB cases identified in a recent survey had visited health facilities in Kenya with suggestive symptoms but were never diagnosed. The failure to detect tuberculosis in patients who are already admitted in hospital represents a missed opportunity to provide optimal care.
Researchers at KEMRI-Wellcome carried out a study to design a contextually appropriate and theory-informed intervention to improve case detection of TB in children in Kenyan hospitals. The study employed the Behaviour Change Wheel (BCW), due its recognition that individual and collective behaviour change is key to implementing new practices and to improve health outcomes. In addition, it naturally incorporates context, which is key to effective design and implementation of interventions.
In this brief, Dr Jacquie Oliwa discuss Improving case detection of tuberculosis in hospitalised Kenyan children