Monthly cough days to increase TB screening at the community level: experience from Sofala Province, Mozambique

Beginning in October 2016, this activity brought together community DOT supervisors, activists, local health facility staff, and local leadership to conduct TB screening and sensitization in pre-selected community locations. One day per month, a community sensitization session was delivered, and all people with presumptive TB were referred to health facilities for further investigation. The intervention contributed to an increase in diagnosis of all forms of TB in Sofala province by 3% in 2016 and 8% in 2017. Community-based DOTS activities in Sofala province accounted for 23% of total TB case notification in 2016 and 39% in 2017. Out of this, the monthly cough day contribution to community-based DOTS case notification was 13% in 2016 and 20% in 2017. The trend in TB case notification through community-based DOTS monthly cough days showed an increasing trend in all quarters in 2017 compared to 2016. The monthly cough day approach has the potential to increase TB case detection and improve access to TB care by bringing health services closer to communities. This approach was implemented in all districts of Sofala province, with projected intensified efforts in the future. The results of the monthly cough day intervention suggest that community-based TB activities can be an effective strategy for increasing TB case detection and improving access to TB care. The success of the monthly cough day approach can be attributed to the collaboration between community DOT supervisors, activists, local health facility staff, and local leadership. This collaboration enabled the effective delivery of TB screening and sensitization services in pre-selected community locations. The results of the intervention also highlight the importance of community-based TB activities in increasing TB case detection and improving access to TB care. The implementation of monthly cough days in Sofala province demonstrates the potential of community-based TB activities to improve TB case detection and access to TB care. The results of the intervention suggest that this approach can be an effective strategy for increasing TB case detection and improving access to TB care, particularly in areas with limited access to health facilities.