Trends in TB case notification over fifteen years: the case notification of 25 Districts of Arsi Zone of Oromia Regional State, Central Ethiopia

BMC Public Health

Bernt Lindtjørn¹  Meaza Demissie²  Shallo Daba Hamusse¹ 

[1] Centre for International Health, University of Bergen, Bergen, Norway;Addis Continental Institute of Public Health, Addis Ababa, Ethiopia

关键词: Ethiopia;    Arsi zone;    Case notification;    Trends;    TB;   

Others  :  1131722
DOI  :  10.1186/1471-2458-14-304

 received in 2013-11-08, accepted in 2014-03-24,  发布年份 2014

【 摘 要 】

Background

The aims of tuberculosis (TB) control programme are to detect TB cases and treat them to disrupt transmission, decrease mortality and avert the emergence of drug resistance. In 1992, DOTS strategy was started in Arsi zone and since 1997 it has been fully implemented. However, its impact has not been assessed. The aim of this study was, to analyze the trends in TB case notification and make a comparison among the 25 districts of the zone.

Methods

A total of 41,965 TB patients registered for treatment in the study area between 1997 and 2011 were included in the study. Data on demographic characteristics, treatment unit, year of treatment and disease category were collected for each patient from the TB Unit Registers.

Results

The trends in all forms of TB and smear positive pulmonary TB (PTB+) case notification increased from 14.3 to 150 per 100,000 population, with an increment of 90.4% in fifteen years. Similarly, PTB+ case notification increased from 6.9 to 63 per 100,000 population, an increment of 89% in fifteen years. The fifteen-year average TB case notification of all forms varied from 60.2 to 636 (95% CI: 97 to 127, P<0.001) and PTB+ from 10.9 to 163 per 100,000 population (95% CI: 39 to 71, p<0.001) in the 25 districts of the zone. Rural residence (AOR, 0.23; 95% CI: 0.21 to 0.26) and districts with population ratio to DOTS sites of more than 25,000 population (AOR, 0.40; 95% CI: 0.35 to 0.46) were associated with low TB case notification. TB case notifications were significantly more common among 15-24 years of age (AOR, 1.19; 95% CI:1.03 to 1.38), PTB- (AOR, 1.46; 95% CI: 1.33 to 64) and EPTB (AOR, 1.49; 95% CI; 1.33 to 1.60) TB cases.

Conclusions

The introduction and expansion of DOTS in Arsi zone has improved the overall TB case notification. However, there is inequality in TB case notification across 25 districts of the zone. Further research is, recommended on the prevalence, incidence of TB and TB treatment outcome to see the differences in TB distribution and performance of DOTS in treatment outcomes among the districts.

【 授权许可】

   
2014 Hamusse et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]World Health Organisation: The World Health Report Changing History. Geneva: WHO; 2004.
• [2]World Health Organization (WHO): An International Road Map for Tuberculosis Research: Towards a World Free of Tuberculosis. Geneva: WHO; 2011.
• [3]World Health Organization (WHO): Global Tuberculosis Report. Geneva: WHO; 2012.
• [4]World Health Organization: Global Tuberculosis Report. Geneva: WHO; 2011.
• [5]Yassin MA, Datiko DG, Shargie EB: Ten-year experiences of the tuberculosis control programme in the southern region of Ethiopia. Int J Tuberc Lung Dis 2006, 10(10):1166-1171. PubMed PMID: 17044212 Epub 2006/10/19. eng
• [6]Keshavje S, Farmer PE: Tuberculosis, Drug Resistance, and the History of Modern Medicine. N Engl J Med 2012, 367:931-936.
• [7]World Health Organization (WHO): Global Tuberculosis Report. Geneva: WHO; 2009.
• [8]Ministry of Health of Ethiopia (MOH): Tuberculosis, Leprosy and TB/HIV Prevention and Control Programme Manual. 4th edition. Addis Ababa: MOH; 2008.
• [9]Federal Ministry of Health of Ethiopia (FMOH): First Ethiopian National Population Based Tuberculosis Prevalence Survey. Addis Ababa, Ethiopia: FMOH; 2011.
• [10]Tadesse T, Demissie M, Berhane Y, Kebede Y, Abebe M: Two-thirds of smear-positive tuberculosis cases in the community were undiagnosed in Northwest Ethiopia: population based cross-sectional study. PLoS ONE 2011, 6(12):e28258. PubMed PMID: 22164256 Pubmed Central PMCID: 3229563 Epub 2011/12/14. eng
• [11]Shargie EB, Yassin MA, Lindtjorn B: Prevalence of smear-positive pulmonary tuberculosis in a rural district of Ethiopia. Int J Tuberc Lung Dis 2006, 10(1):87-92. PubMed PMID: 16466043 Epub 2006/02/10. eng
• [12]Shargie EB, Morkve O, Lindtjorn B: Tuberculosis case-finding through a village outreach programme in a rural setting in southern Ethiopia: community randomized trial. Bull World Health Organ 2006, 84(2):112-119. PubMed PMID: 16501728 Pubmed Central PMCID: 2626531 Epub 2006/02/28. eng
• [13]Deribew A, Abebe G, Apers L, Abdissa A, Deribe F, Woldemichael K, Jira C, Tesfaye M, Shiffa J, Aseffa A, Bezabih M, Abeje T, Colebunders R: Prevalence of pulmonary TB and spoligotype pattern of Mycobacterium tuberculosis among TB suspects in a rural community in Southwest Ethiopia. BMC Infect Dis 2012, 12(1):54. PubMed PMID: 22414165 Epub 2012/03/15. Eng BioMed Central Full Text
• [14]Demissie M, Zenebere B, Berhane Y, Lindtjorn B: A rapid survey to determine the prevalence of smear-positive tuberculosis in Addis Ababa. Int J Tuberc Lung Dis 2002, 6(7):580-584. PubMed PMID: 12102296, Epub 2002/07/10. eng
• [15]Tadesse T, Demissie M, Berhane Y, Kebede Y, Abebe M: The Clustering of Smear-Positive Tuberculosis in Dabat, Ethiopia: A Population Based Cross Sectional Study. PLOS ONE 2013, 8(5):e65022. http://www.plosone.org webcite
• [16]Yassin MADDG, Olivia T, Markos P, Aschalew M, Shargie EB DH, Mesay RK, Suvanand S, Blok EL, Sally T: Innovative Community-Based Approaches Doubled Tuberculosis Case Notification and Improved Treatment Outcome in Southern Ethiopia. PLOS ONE 2013, 8(5):e63174.
• [17]Tiwari N, Adhikari C, Tewari A, Kandapol V: Investigation of geo-spatial hotspots for the occurrence of tuberculosis in Almora district, India, using GIS and spatial scan statistic. Int J Health Geogr 2006, 5:33. DOI: 10.1186/1476-072X-5-33 BioMed Central Full Text
• [18]Nunes C: Tuberculosis incidence in Portugal: spatiotemporal clustering. Int J Health Geogr 2007, 6:30. doi: 10.1186/1476-072X-6-30 BioMed Central Full Text
• [19]Munch SWPVL Z, Booysen CN, Zietsman HL, Enarson DA, Beyers N: Tuberculosis transmission patterns in a high-incidence area: a spatial analysis. INT J TUBERC LUNG DIS 2003, 7(3):271-277.
• [20]Touray K, Adetifa IM, Jallow A, Rigby J, Jeffries D, Cheung YB, Donkor S, Adegbola RA, Hill PC: Spatial analysis of tuberculosis in an Urban West African setting: Is there evidence of clustering? Trop Med Int Health 2010, 15(6):664-672.
• [21]Getahun B, Ameni G, Biadgilign S, Medhin G: Mortality and associated risk factors in a cohort of tuberculosis patients treated under DOTS programme in Addis Ababa, Ethiopia. BMC Infect Dis 2011, 11:127. PubMed PMID: 21575187. Pubmed Central PMCID: 3118140. Epub 2011/05/18. eng BioMed Central Full Text
• [22]Federal Ministry of Health of Ethiopia (FMOH): National TB/Leprosy Control Program Report. Addis Ababa: FMOH; 2010.
• [23]Shargie EB, Lindtjorn B: DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: a retrospective trend analysis. BMC Public Health 2005, 6(5):5-62. PubMed PMID: 15938746. Pubmed Central PMCID: 1173119. Epub 2005/06/09. eng
• [24]Berhe G, Enquselassie F, Aseffa A: Treatment outcome of smear-positive pulmonary tuberculosis patients in Tigray Region, Northern Ethiopia. BMC Public Health 2012, 12:537. BioMed Central Full Text
• [25]Oromia Regional Health Bureau (ORHB): Annual Report Of Health Service and Health Programme. Addis Ababa, Ethiopia: ORHB; 2011.
• [26]Datiko DG, Yassin MA, Chekol LT, Kabeto LE, Lindtjorn B: The rate of TB-HIV co-infection depends on the prevalence of HIV infection in a community. BMC Public Health 2008, 8:266. PubMed PMID: 18667068. Pubmed Central PMCID: 2542368. Epub 2008/08/01. eng BioMed Central Full Text
• [27]Narasimhan R, Wood J, RainaMacIntyre C, Mathai D: Risk Factors for Tuberculosis. Hindawi Publishing Corporation Pulmonary Medicine. 2013. http://dxdoiorg/101155/2013/828939 webcite
• [28]Dlodlo RA, Fujiwara PI, Enarson DA: Should tuberculosis treatment and control be addressed differently in HIV-infected and -uninfected individuals? Eur Respir J 2004, 25(4):11-17.
• [29]Central Statistical Agency (Ethiopia) and ORC Macro: Ethiopia Demographic and Health Survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro; 2007.
• [30]Central Statistical Agency (CSA): Ethiopian Population and Housing Census. Addis Ababa, Ethiopia: CSA; 1997.
• [31]Keshavje S, Farmer PE: Tuberculosis Drug Resistance and the History of Modern Medicine. NEJ M 2012, 367:931-936.
• [32]Huong NT, Duong BD, Co NV, Quy HT, Tung LB, Bosman MC, Gebhardt AC, Velema JP, Broekmans JF, Borgdorff MW: Establishment and development of the National Tuberculosis Control Programme in Vietnam. Int J Tuberc Lung Dis 2005, 9(2):151-156.
• [33]Datiko DG, Lindtjorn B: Health extension workers improve tuberculosis case detection and treatment success in southern Ethiopia: a community randomized trial. PLoS ONE 2009, 4(5):e5443. PubMed PMID: 19424460. Pubmed Central PMCID: 2678194. Epub 2009/05/09. eng
• [34]Obermeyer Z, Abbott-Klafter J, Christopher J, Murray L: Has the DOTS Strategy Improved Case Finding or Treatment Success? An Empirical Assessment. PLoS ONE 2008, 3(3):e1721. http://www.plosone.org webcite
• [35]Corbett EL, Watt CJ, Walker N, Maher D, Williams BG: The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 2003, 163:1009-1021.
• [36]Dye C, Garnett GP, Sleeman K, Williams BG: Prospects for worldwide tuberculosis control under the WHO DOTS strategy. Lancet 1998, 352:1886-1891.
• [37]Tessema B, Beer J, Merker M, Emmrich F, Sack U, Rodloff AC, Niemann S: Molecular epidemiology and transmission dynamics of Mycobacterium tuberculosis in Northwest Ethiopia: new phylogenetic lineages found in Northwest Ethiopia. BMC Infect Dis 2013., 13(131) http://wwwbiomedcentralcom/1471-2334/13/131 webcite
• [38]Randremanana RV, Sabatier P, Rakotomanana F, Randriamanantena A, Richard V: Spatial clustering of pulmonary tuberculosis and impact of the care factors in Antananarivo City. Trop Med Int Health 2009, 14(4):429-437.