title: Assigning focal persons to notify more tuberculosis patients: lessons learned in southern Ethiopia.
abstract: METHODS
  Health centres in Southern Ethiopia.
  
  
  OBJECTIVE
  To determine factors contributing to the large variations in the notification of smear-positive tuberculosis (TB) cases.
  
  
  METHODS
  A cross-sectional study in selected health centres from areas with high and low case notification was conducted and health system and health care worker (HCW) related determinants were examined.
  
  
  RESULTS
  A total of 50 (61.0%) health centres and 172 (65.2%) HCWs from high case notification areas, and 32 (39.0%) health centres and 92 (33.8%) HCWs from low case notification areas were included in the study. Assignment of a full-time TB focal person at the TB clinic (adjusted odds ratio [aOR] 5.8, 95%CI 1.5-22.4) and availability of TB recording tools (aOR 7.0, 95%CI 1.5-32.5) were independent predictors of high case notification rates. HCW knowledge about TB screening, diagnosis and treatment was positively associated with case notification (aOR 2.53, 95%CI 1.42-4.48).
  
  
  CONCLUSIONS
  Increased TB case notification was associated with the presence of a full-time focal person, availability of TB recording tools and good knowledge about TB among HCWs. Putting in place these measures in all health centres could increase TB notification in the region.
authors.affiliation: College of Medicine and Health Sciences, School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
authors.forename: T
authors.initials: T
authors.lastname: Solomon
authors.affiliation: Southern Nations, Nationalities and People Regional (SNNPR) State Health Bureau, Hawassa, Ethiopia.
authors.forename: M
authors.initials: M
authors.lastname: Shiferaw
authors.affiliation: Southern Nations, Nationalities and People Regional (SNNPR) State Health Bureau, Hawassa, Ethiopia.
authors.forename: W
authors.initials: W
authors.lastname: Abreham
authors.affiliation: Aleta Wondo Town Health Centre, SNNPR, Hawassa, Ethiopia.
authors.forename: B
authors.initials: B
authors.lastname: Tayu
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands ; Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Klinkenberg
authors.affiliation: College of Medicine and Health Sciences, School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
authors.forename: E
authors.initials: E
authors.lastname: Loha
keywords: TB-related training; case finding; case notification; supervision