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Trends of tuberculosis case notification and treatment outcomes in the Sidama Zone, southern Ethiopia: ten-year retrospective trend analysis in urban-rural settings.

Dangisso MH, Datiko DG, Lindtjørn B - PLoS ONE (2014)

Bottom Line: The treatment success was higher in rural areas (AOR 1.11; CI 95%: 1.03-1.2), less for PTB- (AOR 0.86; CI 95%: 0.80-0.92) and higher for extra-pulmonary TB (AOR 1.10; CI 95%: 1.02-1.19) compared to PTB+.Over the past decade TB CNRs and treatment outcomes improved, whereas the disparities of disease burden by gender and place of residence reduced and mortality declined.Strategies should be devised to address higher risk groups for poor treatment outcomes.

View Article: PubMed Central - PubMed

Affiliation: Center for International Health, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Sidama Zone Health Department, Hawassa, Ethiopia.

ABSTRACT

Background: Ethiopia is one of the high tuberculosis (TB) burden countries. An analysis of trends and differentials in case notifications and treatment outcomes of TB may help improve our understanding of the performance of TB control services.

Methods: A retrospective trend analysis of TB cases was conducted in the Sidama Zone in southern Ethiopia. We registered all TB cases diagnosed and treated during 2003-2012 from all health facilities in the Sidama Zone, and analysed trends of TB case notification rates and treatment outcomes.

Results: The smear positive (PTB+) case notification rate (CNR) increased from 55 (95% CI 52.5-58.4) to 111 (95% CI 107.4-114.4) per 105 people. The CNRs of PTB+ in people older than 45 years increased by fourfold, while the mortality of cases during treatment declined from 11% to 3% for smear negative (PTB-) (X2trend, P<0.001) and from 5% to 2% for PTB+ (X2trend, P<0.001). The treatment success was higher in rural areas (AOR 1.11; CI 95%: 1.03-1.2), less for PTB- (AOR 0.86; CI 95%: 0.80-0.92) and higher for extra-pulmonary TB (AOR 1.10; CI 95%: 1.02-1.19) compared to PTB+. A higher lost-to-follow up was observed in men (AOR 1.15; CI 95%: 1.06-1.24) and among PTB- cases (AOR 1.14; CI 95%: 1.03-1.25). More deaths occurred in PTB-cases (AOR 1.65; 95% CI: 1.44-1.90) and among cases older than 65 years (AOR 3.86; CI 95%: 2.94-5.10). Lastly, retreatment cases had a higher mortality than new cases (6% vs 3%).

Conclusion: Over the past decade TB CNRs and treatment outcomes improved, whereas the disparities of disease burden by gender and place of residence reduced and mortality declined. Strategies should be devised to address higher risk groups for poor treatment outcomes.

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Trends of TB case notification rates per 105 people by year and by TB category in the Sidama Zone, 2003–2012.
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pone-0114225-g001: Trends of TB case notification rates per 105 people by year and by TB category in the Sidama Zone, 2003–2012.

Mentions: The case notification for all forms of TB steadily increased between 2003–2012 (Figure 1). PTB+ CNR declined from 55 per 105 people in 2003 to 51 per 105 people in 2006 (X2trend, P = 0.004), while increasing from 58 (95% CI 55.8–61.3) per 105 people in 2007 to 111 (95% CI 107.4–114.4) in 2012. The case notification of PTB+ in rural settings declined to 46 per 105 people in 2006 (X2trend, P = 0.002), and increased to 110 (95% CI; 106.3–113.5) in 2012. In 2011, the CNR of PTB+ doubled for men and women compared to what it was in 2003 (Table 3). The disparity between men and women in CNR declined from 16 per 105 people in 2003 to 8 per 105 people in 2012, while the male to female (M: F) ratio declined from 1.4∶1 to 1.1∶1. Likewise, the CNR of PTB+ in the 45 year and above age groups rose by nearly fourfold (Table 3).


Trends of tuberculosis case notification and treatment outcomes in the Sidama Zone, southern Ethiopia: ten-year retrospective trend analysis in urban-rural settings.

Dangisso MH, Datiko DG, Lindtjørn B - PLoS ONE (2014)

Trends of TB case notification rates per 105 people by year and by TB category in the Sidama Zone, 2003–2012.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4252125&req=5

pone-0114225-g001: Trends of TB case notification rates per 105 people by year and by TB category in the Sidama Zone, 2003–2012.
Mentions: The case notification for all forms of TB steadily increased between 2003–2012 (Figure 1). PTB+ CNR declined from 55 per 105 people in 2003 to 51 per 105 people in 2006 (X2trend, P = 0.004), while increasing from 58 (95% CI 55.8–61.3) per 105 people in 2007 to 111 (95% CI 107.4–114.4) in 2012. The case notification of PTB+ in rural settings declined to 46 per 105 people in 2006 (X2trend, P = 0.002), and increased to 110 (95% CI; 106.3–113.5) in 2012. In 2011, the CNR of PTB+ doubled for men and women compared to what it was in 2003 (Table 3). The disparity between men and women in CNR declined from 16 per 105 people in 2003 to 8 per 105 people in 2012, while the male to female (M: F) ratio declined from 1.4∶1 to 1.1∶1. Likewise, the CNR of PTB+ in the 45 year and above age groups rose by nearly fourfold (Table 3).

Bottom Line: The treatment success was higher in rural areas (AOR 1.11; CI 95%: 1.03-1.2), less for PTB- (AOR 0.86; CI 95%: 0.80-0.92) and higher for extra-pulmonary TB (AOR 1.10; CI 95%: 1.02-1.19) compared to PTB+.Over the past decade TB CNRs and treatment outcomes improved, whereas the disparities of disease burden by gender and place of residence reduced and mortality declined.Strategies should be devised to address higher risk groups for poor treatment outcomes.

View Article: PubMed Central - PubMed

Affiliation: Center for International Health, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Sidama Zone Health Department, Hawassa, Ethiopia.

ABSTRACT

Background: Ethiopia is one of the high tuberculosis (TB) burden countries. An analysis of trends and differentials in case notifications and treatment outcomes of TB may help improve our understanding of the performance of TB control services.

Methods: A retrospective trend analysis of TB cases was conducted in the Sidama Zone in southern Ethiopia. We registered all TB cases diagnosed and treated during 2003-2012 from all health facilities in the Sidama Zone, and analysed trends of TB case notification rates and treatment outcomes.

Results: The smear positive (PTB+) case notification rate (CNR) increased from 55 (95% CI 52.5-58.4) to 111 (95% CI 107.4-114.4) per 105 people. The CNRs of PTB+ in people older than 45 years increased by fourfold, while the mortality of cases during treatment declined from 11% to 3% for smear negative (PTB-) (X2trend, P<0.001) and from 5% to 2% for PTB+ (X2trend, P<0.001). The treatment success was higher in rural areas (AOR 1.11; CI 95%: 1.03-1.2), less for PTB- (AOR 0.86; CI 95%: 0.80-0.92) and higher for extra-pulmonary TB (AOR 1.10; CI 95%: 1.02-1.19) compared to PTB+. A higher lost-to-follow up was observed in men (AOR 1.15; CI 95%: 1.06-1.24) and among PTB- cases (AOR 1.14; CI 95%: 1.03-1.25). More deaths occurred in PTB-cases (AOR 1.65; 95% CI: 1.44-1.90) and among cases older than 65 years (AOR 3.86; CI 95%: 2.94-5.10). Lastly, retreatment cases had a higher mortality than new cases (6% vs 3%).

Conclusion: Over the past decade TB CNRs and treatment outcomes improved, whereas the disparities of disease burden by gender and place of residence reduced and mortality declined. Strategies should be devised to address higher risk groups for poor treatment outcomes.

Show MeSH
Related in: MedlinePlus