Geographic availability of and physical accessibility to tuberculosis diagnostic tests in Ghana: a cross-sectional survey

Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sit...

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Veröffentlicht in:BMC health services research Jg. 23; H. 1; S. 755 - 11
Hauptverfasser: Kuupiel, Desmond, Cheabu, Benjamin S. N., Yeboah, Peter, Duah, James, Addae, Joseph K., Ako-Nnubeng, Ignatius T., Osei, Francis A., Ziblim, Shamsu-Deen, Mchunu, Gugu G., Pillay, Julian D., Bawontuo, Vitalis
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 14.07.2023
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ISSN:1472-6963, 1472-6963
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Abstract Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. Methods We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Results Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. Conclusion This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
AbstractList BackgroundIn Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests.MethodsWe assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour.ResultsOf the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions.ConclusionThis study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests.BACKGROUNDIn Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests.We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour.METHODSWe assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour.Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions.RESULTSOf the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions.This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.CONCLUSIONThis study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 [+ or -] 13.8 km and 67.6 [+ or -] 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 [+ or -] 14.6 km and 108.3 [+ or -] 43.9 min, whilst UER recorded the shortest with 10.2 [+ or -] 5.8 km and 29.1 [+ or -] 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to [less than or equai to] 10 km.
In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. Methods We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Results Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 [+ or -] 13.8 km and 67.6 [+ or -] 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 [+ or -] 14.6 km and 108.3 [+ or -] 43.9 min, whilst UER recorded the shortest with 10.2 [+ or -] 5.8 km and 29.1 [+ or -] 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. Conclusion This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to [less than or equai to] 10 km. Keywords: Tuberculosis, Diagnosis, Availability, Physical Accessibility, Ghana
Abstract Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. Methods We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Results Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. Conclusion This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case detection, yet little has been scientifically documented on it in Ghana. This study, therefore, sought to map TB diagnosis sites, and describe the geographic availability and physical accessibility to TB diagnosis in six regions of Ghana to inform scale-up and future placement of TB diagnostic tests. Methods We assembled the geolocation and attribute data of all health facilities offering TB diagnosis in Upper West Region (UWR), Upper East Region (UER), Ahafo, North-East, Northern, and Savannah regions. QGIS was employed to estimate the distance and travel time to TB diagnosis sites within regions. Travel time estimates were based on assumed motorised tricycle speed of 20 km (km)/hour. Results Of the total 1584 health facilities in the six regions, 86 (5.4%) facilities were providing TB diagnostic testing services. This 86 TB diagnosis sites comprised 56 (65%) microscopy sites, 23 (27%) both microscopy and GeneXpert sites, and 7 (8%) GeneXpert only sites (8%). Of the 86 diagnosis sites, 40 (46%) were in the UER, follow by Northern Region with 16 (19%), 12 (14%) in UWR, 9 (10%) in Ahafo Region, 5 (6%) in North East, and 4 (5%) in Savannah Region. The overall estimated mean distance and travel time to the nearest TB diagnosis site was 23.3 ± 13.8 km and 67.6 ± 42.6 min respectively. Savannah Region recorded the longest estimated mean distance and travel time with 36.1 ± 14.6 km and 108.3 ± 43.9 min, whilst UER recorded the shortest with 10.2 ± 5.8 km and 29.1 ± 17.4 min. Based on a 10 km buffer of settlement areas, an estimated 75 additional TB diagnosis sites will be needed to improve access to TB diagnosis services across the six regions. Conclusion This study highlights limited availability of TB diagnosis sites and poor physical accessibility to TB diagnosis sites across five out of the six regions. Targeted implementation of additional TB diagnosis sites is needed to reduce travel distances to ≤ 10 km.
ArticleNumber 755
Audience Academic
Author Cheabu, Benjamin S. N.
Mchunu, Gugu G.
Kuupiel, Desmond
Bawontuo, Vitalis
Yeboah, Peter
Ako-Nnubeng, Ignatius T.
Pillay, Julian D.
Duah, James
Osei, Francis A.
Addae, Joseph K.
Ziblim, Shamsu-Deen
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  organization: Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Faculty of Health Sciences, Durban University of Technology, Ritson Campus
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  givenname: Peter
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  fullname: Yeboah, Peter
  organization: Christian Health Association of Ghana
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  organization: Christian Health Association of Ghana
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  organization: Christian Health Association of Ghana
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  givenname: Gugu G.
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  fullname: Mchunu, Gugu G.
  organization: Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal
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  givenname: Vitalis
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  organization: Department of Health Services Management and Administration, School of Business, SD Dombo University of Business and Integrated Development Studies (SDD-UBIDS)
BackLink https://www.ncbi.nlm.nih.gov/pubmed/37452305$$D View this record in MEDLINE/PubMed
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CitedBy_id crossref_primary_10_1371_journal_pone_0329984
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Issue 1
Keywords Availability
Ghana
Tuberculosis
Physical Accessibility
Diagnosis
Language English
License 2023. The Author(s).
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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Snippet Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role...
In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case...
Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role...
In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role in TB case...
BackgroundIn Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an essential role...
Abstract Background In Ghana, tuberculosis (TB) case detection is low (< 34%). Existing scientific evidence suggest access to TB diagnostic tests play an...
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SubjectTerms Acquired immune deficiency syndrome
AIDS
Analysis
Availability
Care and treatment
COVID-19
Cross-Sectional Studies
Datasets
Demographic aspects
Design
Diagnosis
Diagnostic Services
Diagnostic Tests, Routine
Ferries
Geographic information systems
Geography
Ghana
Ghana - epidemiology
Health Administration
Health facilities
Health Informatics
Health services
Health Services Accessibility
Humans
Laboratories
Medical diagnosis
Medical tests
Medicine
Medicine & Public Health
Microscopy
Nursing Research
Physical Accessibility
Public Health
Regions
Roads & highways
Travel
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - epidemiology
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Title Geographic availability of and physical accessibility to tuberculosis diagnostic tests in Ghana: a cross-sectional survey
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