Family Matrix Improves TB Case Detection in Rural Ethiopia

Family Matrix Improves TB Case Detection in Rural Ethiopia

 {Photo Credit: Abel Helebo/MSH.}Silenat with her three-year-old child, her husband Yirga, and Tadele, a TB focal person at the Keraniyo Health Center.Photo Credit: Abel Helebo/MSH.

Silenat Yihune, a 40-year-old woman, mother, and housewife, lives in a remote region of Huletejuenesie District, Ethiopia, which is approximately 20 kilometers from the closest health facility. For nine months Silenat suffered from a cough, chest pain, fever, and weight loss, but was unable to receive treatment. As is common among Ethiopian families, Silenat was economically dependent upon her husband. He refused to pay for her travel to the distant health facility. Several months later, Silenat’s husband, Yirga, started to show similar symptoms and visited the Keraniyo Health Center, where he was diagnosed with tuberculosis (TB).

Keraniyo Health Center is one of the health facilities in Huletejunesie district supported by the PEPFAR-funded, USAID project, Help Ethiopia Address Low TB Performance (HEAL TB), led by Management Sciences for Health (MSH).

Last year, HEAL TB trained two health workers at the Keraniyo Health Center to use a family matrix system to prioritize TB screening for family members of TB patients. One of these health workers, Tadele, diagnosed Yirga with TB and helped him to start treatment. He then recorded all of his family members’ names onto the family matrix and advised Yirga to bring them to Keraniyo for TB screening. Having personally experienced the benefits of TB treatment, Yirga complied with this recommendation. Upon testing Yirga’s family members, Tadeo discovered that Silenat was also suffering from TB.

The health care team at Keraniyo immediately started her on TB treatment.

Now, two months later, Silenat is no longer coughing and she has gained weight. She said:

If it wasn’t for the effort of Tadele and the health team, I would have continued to suffer. I cannot imagine what could have happened if we had stayed home and did not seek treatment. I am happy now that I can be there for my children.

The family matrix system has benefited many women in Ethiopia who are not supported by their male partners to access health care. In the past year, health workers in the Huletejuenesie District have used the family matrix to conduct TB tests for 283 family members of TB patients. Among these, nine individuals have been diagnosed and treated for TB and are no longer suffering.

Over the past five months, HEAL TB has trained an additional 631 health workers from 348 health centers to use the family matrix. These health workers continue to receive technical support and mentoring from HEAL TB as they incorporate the family matrix into their clinical practice. HEAL TB also encourages trained health workers to teach their colleagues to use the family matrix system so that this TB outreach strategy will continue to expand throughout Ethiopia.

Dr. Abel Helebo is a technical associate of HEAL TB at MSH.

Editor's note, January 29, 2014: This story appears in the MSH 2014 Success Story Compendium as "Simple Family Matrix Improves TB Case Detection in Rural Ethiopia".

Editor's note, March 7, 2013: This post is part of a World TB Day 2013 series on what works to stop TB. Join the conversation in the comments and on Twitter with hashtags " href="" target="_blank"> and " href="" target="_blank">.