Household Contact Tuberculosis Screening Adherence and Associated Factors Among Pulmonary Tuberculosis Patients on Follow-Up at Health Facilities in Shashamane Town, Southeast Ethiopia

Adisu Naga Mamo,1 Robdu Furi Gilo,2,&ast; Ashetu Fikadu Tesema,3,&ast; Negash Fetene Worku,4 Tadese Teshome Kenea,5 Dinka Kebede Dibisa,6 Yonas Adisu Dagafa,7 Lamessa Dube8,&ast; 1Department of Public Health Emergency Management, Kelem Wallaga Zonal Health Office, Dambi Dollo, Oromia, Ethiopia; 2Department of Pediatrics, Shala District Health Office, Shashamane, Oromia, Ethiopia; 3Department of Medical Laboratory Sciences, Institute of Health Science, Dambi Dollo University, Dambi Dollo, Oromia, Ethiopia; 4Department of Diseases Prevention and Control, Yaya Gulale District Health Office, Fiche, Oromia, Ethiopia; 5Department of Public Health Emergency Management, Sire Hospital, Nekemte, Oromia, Ethiopia; 6Department of Diseases Prevention and Control, Setema District Health Office, Jimma, Oromia, Ethiopia; 7Department of Medical Laboratory Sciences, Institute of Health Science, Wallaga University, Nekemte, Oromia, Ethiopia; 8Department of Epidemiology, Institute of Health Science, Jimma University, Jimma, Oromia, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Adisu Naga Mamo, Tel +251917712305, Email obsanega8@gmail.comBackground: The greatest risk of getting tuberculosis (TB) infection is contact with patients who have pulmonary tuberculosis (PTB). The World Health Organization (WHO) strongly recommends tuberculosis screening for all household contacts of PTB patients. However, there is no information on household contact screening adherence among PTB patients in Shashamane town.Methods: A facility-based mixed-method cross-sectional study was conducted from July 1 to November 30, 2021 among consecutively selected 392 PTB patients and 23 purposely selected key informants. Data were collected using a pre-tested interviewer administered questionnaire and leading questions. Data analysis was made using SPSS version 25 and in-depth interview information was analyzed based on thematic areas. Bivariable followed by multivariable logistic regression with 95% CI were conducted. P-value< 0.05 was considered to identify statistically significant factors.Results: The overall adherence to household contact screening (HHCS) was 44.4% (95% CI: 39.3, 49.1). Having under fifteen years of contact (AOR=2.386, 95% CI: 1.44, 3.96), diploma and above education status (AOR=3.43, 95% CI: 1.286, 9.15), good knowledge (AOR=2.999, 95% CI: 1.79, 5.03), favorable attitude (AOR=2.409, 95% CI: 1.45, 4.02), getting health education (AOR=3.287, 95% CI: 1.92, 5.63) and smear positive type of PTB (AOR=2.156, 95% CI: 1.28, 3.62) were factors significantly associated with HHCS adherence. Workload, facility readiness and care provide commitments were also identified from qualitative data.Conclusion and Recommendation: HHCS adherence in our study was sub-optimal referenced to WHO and national recommendations that all household contact should be screened. Having age less than fifteen years contact, education status, knowledge, attitude, receiving health education and type of pulmonary tuberculosis were factors associated with adherence. We recommend increasing community awareness of TB, providing health education TB patients and their families, strengthening positive attitudes toward HHC screening and strengthening the commitment of health professionals to screen for HHCs.Keywords: adherence, household, contact, screening, pulmonary tuberculosis