{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:42:09Z","timestamp":1771058529832,"version":"3.50.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["143350"],"award-info":[{"award-number":["143350"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Loss of patients in the latent tuberculosis infection (LTBI) cascade of care is a major barrier to LTBI management. We evaluated the impact and acceptability of local solutions implemented to strengthen LTBI management of household contacts (HHCs) at an outpatient clinic in Ghana.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Local solutions to improve LTBI management were informed by a baseline evaluation of the LTBI cascade and questionnaires administered to index patients, HHCs, and health care workers at the study site in Offinso, Ghana. Solutions aimed to reduce patient costs and improve knowledge. We evaluated the impact and acceptability of the solutions. Specific objectives were to: 1) Compare the proportion of eligible HHCs completing each step in the LTBI cascade of care before and after solution implementation; 2) Compare knowledge, attitude, and practices (KAP) before and after solution implementation, based on responses of patients and health care workers (HCW) to structured questionnaires; 3) Evaluate patient and HCW acceptability of solutions using information obtained from these questionnaires.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Pre and Post-Solution LTBI Cascades included 58 and 125 HHCs, respectively. Before implementation, 39% of expected &lt;\u20095-year-old HHCs and 66% of \u22655-year-old HHCs were identified. None completed any further cascade steps. Post implementation, the proportion of eligible HHCs who completed identification, assessment, evaluation, and treatment initiation increased for HHCs &lt;\u20095 to 94, 100, 82, 100%, respectively, and for HHCs \u22655 to 96, 69, 67, 100%, respectively. Pre and Post-Solutions questionnaires were completed by 80 and 95 respondents, respectively. Study participants most frequently mentioned financial support and education as the solutions that supported LTBI management.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Implementation of locally selected solutions was associated with an increase in the proportion of HHCs completing all steps in the LTBI cascade. Tuberculosis programs should consider prioritizing financial support, such as payment for chest x-rays, to support LTBI cascade completion.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12879-020-05060-0","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T17:04:17Z","timestamp":1589821457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Solutions to improve the latent tuberculosis Cascade of Care in Ghana: a longitudinal impact assessment"],"prefix":"10.1186","volume":"20","author":[{"given":"Leila","family":"Barss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Obeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Fregonese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Oxlade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Adomako","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony Opoku","family":"Afriyie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica Dapaah","family":"Frimpong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Winters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Valiquette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-4514","authenticated-orcid":false,"given":"Dick","family":"Menzies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,18]]},"reference":[{"key":"5060_CR1","volume-title":"Global tuberculosis report 2015","author":"World Health Organization","year":"2015","unstructured":"World Health Organization. Global tuberculosis report 2015. Geneva: World Health Organization; 2015."},{"key":"5060_CR2","volume-title":"Latent TB Infection : Updated and consolidated guidelines for programmatic management. Licence: CC BY-NC-SA 30 IGO","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. Latent TB Infection : Updated and consolidated guidelines for programmatic management. Licence: CC BY-NC-SA 30 IGO 2018."},{"issue":"11","key":"5060_CR3","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1016\/S1473-3099(16)30216-X","volume":"16","author":"H Alsdurf","year":"2016","unstructured":"Alsdurf H, Hill PC, Matteelli A, Getahun H, Menzies D. The cascade of care in diagnosis and treatment of latent tuberculosis infection: a systematic review and meta-analysis. Lancet Infect Dis. 2016;16(11):1269\u201378.","journal-title":"Lancet Infect Dis"},{"issue":"8","key":"5060_CR4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182185","volume":"12","author":"D Szkwarko","year":"2017","unstructured":"Szkwarko D, Hirsch-Moverman Y, Du Plessis L, Du Preez K, Carr C, Mandalakas AM. Child contact management in high tuberculosis burden countries: a mixed-methods systematic review. PLoS One. 2017;12(8):e0182185.","journal-title":"PLoS One"},{"key":"5060_CR5","unstructured":"World Health Organization. Tuberculosis country profiles. Geneva: World Health Organization; 2018."},{"key":"5060_CR6","volume-title":"The National Tuberculosis Health Sector Strategic Plan for Ghana 2015\u20132020. Ghana Health Service\/Ministry of Health","author":"F Bonsu","year":"2014","unstructured":"Bonsu F, Hanson-Nortey N, Afutu F, Kulevome D, Dzata F, Ahiabu M, et al. The National Tuberculosis Health Sector Strategic Plan for Ghana 2015\u20132020. 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Free tuberculosis diagnosis and treatment are not enough: patient cost evidence from three continents. Int J Tuberc Lung Dis. 2013;17(3):381\u20137.","journal-title":"Int J Tuberc Lung Dis"},{"key":"5060_CR10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s12879-015-0816-0","volume":"15","author":"GJ Fox","year":"2015","unstructured":"Fox GJ, le Loan P, Nhung NV, et al. Barriers to adherence with tuberculosis contact investigation in six provinces of Vietnam: a nested case-control study. BMC Infect Dis. 2015;15:103.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"5060_CR11","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1186\/s12879-018-3116-7","volume":"18","author":"A DeLuca","year":"2018","unstructured":"DeLuca A, Dhumal G, Paradkar M, et al. Addressing knowledge gaps and prevention for tuberculosis-infected Indian adults: a vital part of elimination. BMC Infect Dis. 2018;18(1):202.","journal-title":"BMC Infect Dis"},{"issue":"11","key":"5060_CR12","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.5588\/ijtld.17.0886","volume":"22","author":"N Gil","year":"2018","unstructured":"Gil N, Lopez L, Rodriguez D, et al. Myths and realities about knowledge, attitudes and practices of household contacts of tuberculosis patients. Int J Tuberc Lung Dis. 2018;22(11):1293\u20139.","journal-title":"Int J Tuberc Lung Dis"},{"issue":"4","key":"5060_CR13","first-page":"274","volume":"63","author":"AR Singh","year":"2017","unstructured":"Singh AR, Kharate A, Bhat P, et al. Isoniazid preventive therapy among children living with tuberculosis patients: is it working? A mixed-method study from Bhopal, India. 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Signed informed consent was obtained for all eligible participants before the questionnaire was administered.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"352"}}