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Strategies to reach and motivate migrant communities at high risk for TB to participate in a latent tuberculosis infection screening program: a community-engaged, mixed methods study among Eritreans

Authors
  • Spruijt, Ineke1, 2
  • Haile, Dawit Tesfay2
  • Erkens, Connie1
  • van den Hof, Susan1, 3
  • Goosen, Simone4
  • ten Kate, Andrea5
  • Teshome, Hewan6
  • Karels, Marja7
  • Koenders, Marga8
  • Suurmond, Jeanine2
  • 1 KNCV Tuberculosis Foundation, The Hague, The Netherlands , The Hague (Netherlands)
  • 2 Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands , Amsterdam (Netherlands)
  • 3 Centre for Infectious Disease Control, Bilthoven, The Netherlands , Bilthoven (Netherlands)
  • 4 Netherlands Association of Community Health Services, Utrecht, The Netherlands , Utrecht (Netherlands)
  • 5 Public Health Service IJsselland, Zwolle, The Netherlands , Zwolle (Netherlands)
  • 6 Public Health Service Haaglanden, Den Haag, The Netherlands , Den Haag (Netherlands)
  • 7 Public Health Service Hollands Noorden, Alkmaar, The Netherlands , Alkmaar (Netherlands)
  • 8 Public Health Service Gelderland Zuid, Nijmegen, The Netherlands , Nijmegen (Netherlands)
Type
Published Article
Journal
BMC Public Health
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Mar 12, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12889-020-8390-9
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundIn the Netherlands, migrant populations with a high tuberculosis (TB) incidence are an important target group for TB prevention. However, there is a lack of insight in effective community-engaged strategies to reach and motivate these migrants to participate in latent TB infection (LTBI) screening and treatment programs.MethodsIn cocreation with Eritrean key figures and TB staff, we designed and executed six strategies to reach and motivate Eritrean communities to participate in LTBI programs, in five regions in the Netherlands. We registered participation in LTBI education and screening, and LTBI treatment uptake and completion. We used semi-structured group and individual interviews with Eritrean participants, key figures, and TB staff to identify facilitators and barriers.ResultsUptake of LTBI education (13–75%) and consequent screening (10–124%) varied between strategies. LTBI screening uptake > 100% resulted from educated participants motivating others to participate in screening. Two strategies, using face-to-face promotion and targeting smaller groups, were the most successful. The program resulted in high LTBI treatment initiation and completion (both 97%). Reported program barriers included: competing priorities in the target group, perceived good health, poor risk perception, and scepticism towards the program purpose. TB staff perceived the program as useful but demanding in terms of human resources.ConclusionsEritrean migrant communities can be successfully reached and motivated for LTBI screening and treatment programs, when sufficient (human) resources are in place and community members, well-connected to and trusted by the community, are engaged in the design and execution of the program.

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