Targeted interventions significantly improved TB case detection across the four states. Sustaining these gains requires continuous investment in diagnostics, community engagement, and private sector collaboration. Scaling this model nationally could accelerate Nigeria's progress toward ending TB as a public health threat. Stakeholders are encouraged to support uninterrupted program funding, strengthen health systems, and maintain innovations that bridge existing gaps.

This analysis demonstrates that clinically diagnosed TB cases contribute significantly to transmission and should no longer be excluded from contact tracing protocols. A shift in policy could enhance TB case detection and accelerate progress toward TB elimination goals.

The strategic expansion of TB services across community, public, and private platforms significantly improved TB case detection in Southwest Nigeria. Each model demonstrated unique strengths—community ACF expanded reach to hidden populations, public facility interventions improved service quality, and PPM unlocked new case pools. These results affirm the importance of integrated, multi-platform approaches for sustainable TB service scale-up and epidemic control.