BACKGROUND: Nomadic populations are often isolated
and have difficulty accessing health care, leading to
increased morbidity and mortality. Although Nigeria has
one of the highest tuberculosis (TB) burdens in Africa,
case detection rates remain relatively low.
METHODS: Active case finding for TB among nomadic
populations was implemented over a 2-year period in
Adamawa State. A total of 378 community screening
days was organised with local leaders; community
volunteers provided treatment support. Xpertw MTB/
RIF was available for nomads with negative smear
results.
RESULTS: Through active case finding, 96 376 nomads
were verbally screened, yielding 1310 bacteriologically
positive patients. The number of patients submitting
sputum for smear microscopy statewide increased by
112% compared with the 2 years before the intervention.
New smear-positive notifications increased by
49.5%, while notifications of all forms of TB increased
by 24.5% compared with expected notifications based
on historical trends. Nomads accounted for respectively
31.4% and 26.0% of all smear-positive and TB all forms
notifications. Pre-treatment loss to follow-up and
treatment outcomes were similar among nomads and
non-nomads.
DISCUSSION: Nomads in Nigeria have high TB rates,
and active case finding approaches may be useful in
identifying and successfully treating them. Large-scale
interventions in vulnerable populations can improve TB
case detection.