Engagement of communities and civil society organizations is a critical part of the Post-2015 End TB Strategy. Since 2007, many models of community referral have been implemented to boost TB case detection in Nigeria. Yet clear insights into the comparative TB yield from particular approaches have been limited. We compared four models of active case finding in three Nigerian states. Data on presumptive TB case referral by community workers (CWs), TB diagnoses among referred clients, active case finding model characteristics, and CWs compensation details for 2012 were obtained from implementers and CWs via interviews and log book review. Self-reported performance data were triangulated against routine surveillance data to assess concordance. Analysis focused on assessing the predictors of presumptive TB referral. CWs referred 4–22?% of presumptive TB clients tested, and 4–24?% of the total TB cases detected. The annual median referral per CW ranged widely among the models from 1 to 48 clients, with an overall average of 13.4 referrals per CW. The highest median referrals (48 per CW/yr) and mean TB diagnoses (7.1/yr) per CW (H =70.850, p?
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机译：社区和民间社会组织的参与是2015年后结束结核病战略的重要组成部分。自2007年以来，已经实施了许多社区推荐模型，以提高尼日利亚的结核病案例检测。然而，从特定方法的比较结核病产量的清晰见解受到限制。我们比较了四个尼日利亚州的四个活跃案件的模型。通过社区工人（CWS），TB在推荐客户中诊断的推定TB案例的数据，通过访谈和记录图书评论从实施者和CWS获取2012年的主动案例发现模型特征和2012年的CWS补偿细节。自我报告的绩效数据是针对常规监测数据的三角化，以评估一致性。分析专注于评估推定TB推荐的预测因子。 CWS推荐4-22个？百分比试验的推定TB客户，并检测到总TB案例的4-24％。每CW的年中位数推荐广泛的型号在1到48个客户的范围内广泛传播，平均平均平均每CW的13.4张推荐。通过培训监管的模型获得最高中值（每CW / YR）和平均结核病诊断（7.1 / YR）（H = 70.850，p？0.001），以及80美元/季度付款（综合配额） - 客户的模型）。具有不规则监督，训练和补偿CW的模型贡献了CW / YR每CW / Yr的13个引用的中值，每CW / Yr诊断为0.53μR的平均值。每周花在推定结核病转诊时花费最强的独特贡献（β？= 0.514，p？0.001），以解释控制其他变量之后的推定TB推荐。所有基于社区的TB案例查找项目研究了相对较少数量的症状性的人。 The study shows that incentivized referral, appropriate selection of CWs, supportive supervision, leveraged treatment support roles, and a responsive TB program to receive clients for testing were the key drivers of community TB case finding.
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