Conference Abstract | Volume 9 (ConfProc7): Abstract 096 | Published: 07 Oct 2026
Robert Teye Nyame1,2,&, George Akowuah2, Magdalene Odikro2, Zakaria Adam1,2, Gideon Kye-Doudu2,3, Samuel Sackey2, Ernest Kenu2
1Ghana Health Service, Pusiga District Health Directorate, Upper East Region, 2Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, Legon, Accra, 3 Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Ho, Volta Region
&Corresponding author: Robert Teye Nyame, Ghana Health Service, Pusiga District Health Directorate, Upper East Region, Email: rtonyame@gmail.com
Received: 29 Aug 2025, Accepted: 28 Oct 2025, Published: 07 Oct 2026
Domain: Infectious Disease Epidemiology
This is part of the Proceedings of the 8th Ghana FELTP Scientific Conference and FELTP Competency Graduation, Accra, Ghana, 10 – 11 December, 2025
Keywords: tuberculosis, screening, protocol, Pusiga, Ghana
©Robert Teye Nyame et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Robert Teye Nyame et al. Non-adherence to tuberculosis screening protocol, a critical cause of low case detection in Pusiga District, Ghana, 2025. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfProc7):096. https://doi.org/10.37432/JIEPH-CONFPRO7-0096
Tuberculosis (TB) remains one of the most significant public health challenges globally. TB is a preventable and curable disease, yet it is the second leading cause of death from an infectious disease and the leading cause of death from a single infectious agent worldwide. Pusiga District recorded a total of 9 sputum-positive TB cases as of September 2025, falling below the 60% target for the year. This study was conducted to identify possible factors contributing to low TB case detection in the Pusiga District.
A problem analysis was conducted at Pusiga Health Center. A team of clinicians, data officer, TB/HIV focal person, lab technicians and community health nurses (CHN) brainstormed to identify contributory factors to the problem. Root causes identified were classified based on their level of control as either Total (T), Partial (P) or Not (N) under control. The critical cause was identified as the cause with the highest influence. Results were presented using a fishbone diagram.
The seven participants involved in the brainstorming identified 14 contributory factors. The factors were grouped under four categories as process, staff, policy and population factors. Of these 7 (50.0%) were totally under control, 4 (28.6%) were partially under control and 3 (21.4%) were not under control. The critical cause was the non-adherence to TB screening protocols by health staff which was totally under control to address.
Root causes identified for the low TB case detection in Pusiga District included process, staff, policy and population factors. Non-adherence to TB screening protocols was identified as the critical cause. Regular clinician sensitization on TB screening protocols and healthy education in communities can significantly improve TB case detection in the district.
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