Performance of Active Tuberculosis Screening across the TB Care Cascade in KNCV-Supported Sites in Plateau State, Nigeria: Lessons from the KNCV Nigeria TB LON Project

Introduction: Tuberculosis persists as a public health concern and the leading infectious killer worldwide. Active screening for TB is the best strategy for early diagnosis of TB to curb the spread in communities and ultimately control TB. This study assessed TB screening and treatment cascade performances associated with active tuberculosis case finding in KNCV-supported sites in Plateau State, Nigeria. Methods: The study was conducted in Plateau State, North-Central Nigeria. A prospective study design was used to study all clients irrespective of their age and gender. A proforma was used to extract data from the general facility register and the active case finding (ACF) screening booklets. Data were summarized using absolute numbers and percentages. They were presented using tables and charts. Ethical consideration was duly observed. Result: Over the three years, 1,716,744 clients were studied, out of which 1,707,481 clients were screened (99.5%). The number of clients screened fluctuated, reaching the highest numbers in the period in 2023. Except for the year 2021, females consistently recorded slightly fewer presumptive TB than males over the years (approximately 15,726 - 25,805 among females compared to 14,908 - 28,748 among males), despite a higher number of females being screened. Evaluated presumptive TB showed an upward trend, approximately 14,908 - 15,726 for the year 2021 to 25,805 - 28,748 in the year 2023. TB case detection or yield ranged from 691 to 1894 per sex per year. Of the total 7823 TB cases diagnosed, almost all diagnosed cases were enrolled for treatment. 7514 (96.1%) were enrolled in treatment over the three years. Conclusion: The program demonstrated strong TB screening and treatment cascade performances over the three years, with high screening, evaluation, and treatment initiation rates. Active TB case finding in KNCV-supported sites in Plateau State contributed to improved TB case detection and linkage to care. Further strengthening of targeted screening and community engagement may improve program performance.