Implementingintensified tuberculosis case-finding among street-connected youth and young adults inKenya

Abstract

Background: Street-connected youth and young adults (SCY) suffer a myriad of health problems. In Kenya, SCY are at high risk for tuberculosis (TB) due to their congre- gate living situations. TB screening is not routinely imple- mented in SCY and there has been no published litera- ture on the burden of TB in SCY in western Kenya. Program description: In 2011, the AMPATH TB Pro- gram, an experienced TB screening program, partnered with the Tumaini Center, a trusted street youth organiza- tion, to conduct intensified case finding (ICF) for pulmo- nary TB among SCY. Our program aimed to investigate the numbers of SCY who reported symptoms and those diagnosed with smear-positive pulmonary TB, and link SCY with TB to treatment. Results: Of 116 SCY who were screened, 114 (98%) had a positive questionnaire; 104 (90%) provided a spot spu- tum sample, 39 (34%) provided a morning sputum sam- ple, and 111 (97%) reported cough of >2 weeks. One street youth tested smear-positive for TB and was treated through to cure. Conclusions: Implementing TB ICF is feasible in low-re- source settings through unique collaborations between health care programs and community-based organiza- tions. In addition to identifying smear-positive TB, our program uncovered a high burden of respiratory symp- toms among SCY in Eldoret, Kenya