The introduction of community volunteers significantly enhanced TB contact tracing and TPT enrollment in Ondo State. Their role in raising awareness, generating demand, and supporting adherence proved invaluable in addressing key barriers to preventive care. They also offer a replicable and sustainable model for strengthening and improving TB program performance in similar high-burden, resource-constrained settings.

In fragile, underserved regions where traditional TB programs falter, community-led programming offers a resilient and inclusive pathway to finding the missing cases. By leveraging local actors, cultural fluency, and trust-building mechanisms, this approach illuminates hidden epidemics and reestablishes the community’s trust in health systems. Scaling such community-first models can catalyze a paradigm shift in TB control across humanitarian and post-conflict settings.