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

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

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 des...

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Published in:BMC health services research Vol. 23; no. 1; p. 755
Main Authors: 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
Language:English
Published: England BioMed Central Ltd 14-07-2023
BioMed Central
BMC
Subjects:
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 facilities
Health services
Health Services Accessibility
Humans
Laboratories
Medical diagnosis
Medical tests
Microscopy
Physical Accessibility
Regions
Roads & highways
Travel
Tuberculosis
Tuberculosis - diagnosis
Tuberculosis - epidemiology
Ghana
Ethiopia
Availability
Ghana
Physical Accessibility
Tuberculosis
Diagnosis
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Summary: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.
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ISSN:1472-6963
1472-6963
DOI:10.1186/s12913-023-09755-3