Population-based prevalence survey of tuberculosis in the Tigray region of Ethiopia (original) (raw)
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BMJ Open, 2023
Objective In Ethiopia, one-third of the estimated tuberculosis cases are not detected or reported. Incidence estimates are inaccurate and rarely measured directly. Assessing the 'real' incidence under programme conditions is useful to understand the situation. This study aimed to measure the prevalence and incidence of symptomatic pulmonary tuberculosis (PTB) during 1 year in the adult population of Dale in Ethiopia. Design A prospective population-based cohort study. Setting Every household in Dale was visited three times at 4-month intervals. Participants Individuals aged ≥15 years. Outcome measures Microscopy smear positive PTB (PTB s+), bacteriologically confirmed PTB (PTB b+) by microscopy, GeneXpert, or culture and clinically diagnosed PTB (PTB c+). Results Among 136 181 individuals, 2052 had presumptive TB (persistent cough for 14 days or more with or without haemoptysis, weight loss, fever, night sweats, chest pain or difficulty breathing), in the first round of household visits including 93 with PTB s+, 98 with PTB b+ and 24 with PTB c+; adding those with PTB who were already on treatment, the total number of PTB was 201, and the prevalence was 147 (95% CI: 127 to 168)/100 000 population. Out of all patients with PTB, the proportion detected by symptom screening was in PTB s+ 65%, PTB b+ 67% and PTB c+44%. During 96 388 person-years follow-up, 1909 had presumptive TB, 320 had PTB and the total incidence of PTB was 332 (95% CI: 297 to 370)/100 000 person-years, while the incidence of PTB s+, PTB b+ and PTB c+ was 230 (95% CI: 201 to 262), 263 (95% CI: 232 to 297) and 68 (95% CI: 53 to 86)/100 000 personyears, respectively. Conclusion The prevalence of symptomatic sputum smear-positive TB was still high, only one-third of prevalent PTB cases notified and the incidence rate highest in the age group 25-34 years, indicating ongoing transmission. Finding missing people with TB through repeated symptom screening can contribute to reducing transmission.
Ethiopian Journal of Health Sciences, 2012
Background World Health organization (WHO) declared tuberculosis as a global emergency because it poses a serious public health threat in different countries especially, in Africa. According to WHO report of 2007, Directly Observed Treatment Short course (DOTS) coverage in Ethiopia reached 95 percent of the population; despite this fact the trend of tuberculosis in most of the districts of Ethiopia is not known. Hence, this study has revealed the trend and determined the overall prevalence of smear positive pulmonary tuberculosis in five years (2005/6–2009/10) in Agaro teaching health center, south west Ethiopia. Methods A retrospective study based on record review was conducted at Agaro Teaching Health center on sputum examination record of patient's from 2005/6–2009/10(five years). Socio demographic data and sputum laboratory results were collected using pre-designed questionnaire and the data was entered into a computer using SPSS version 16 for windows. Finally, cross tab an...
Background: Tuberculosis remains a deadly infectious disease, affecting millions of people worldwide. Ethiopia ranks seventh among the twenty two high tuberculosis burden countries. The aim of this study was to determine the prevalence of smear positive pulmonary tuberculosis and its associated risk factors in Goba and Robe hospitals of Bale zone. Methods: A cross-sectional study was conducted on tuberculosis suspected patients from February-May 2012. Sputum samples were examined for acid fast bacilli using Ziehl-Neelsen staining and interview was conducted for each patient. Descriptive statistics, binary logistic and multivariable logistic regression analyses were employed to identify factors associated with pulmonary tuberculosis infection.
Tuberculosis is one of the chronic human disease and serious public health problem in developing countries all over the world. It is the major cause of morbidity and mortality especially in sub-Saharan Africa. This study aimed to assess the prevalence and associated risk factors of smear positive pulmonary tuberculosis among tuberculosis suspected patients at private health institutions in Gondar town. A cross sectional study was conducted at private health institutions on 352 suspected patients. Spot morning sputum was collected and examined by Ziehl-Nelson staining technique. Data was processed by SPSS version 20 software. Out of 352 pulmonary suspected patients who gave sputum samples the prevalence of smear positive pulmonary tuberculosis were 19(5.4%). Among these 12(3.41%) were males while the remaining 7(1.99%) were females. The age ranged from 15 to 91 with mean age of 53 years. Age, average monthly income, low educational status, patients with previous history of chronic disease, contact with tuberculosis suspected cases and ingestion of raw milk were more prone to have pulmonary tuberculosis. So to overcome this problem the responsible bodies should participate to increase the awareness of the community for the prevention and control of tuberculosis.
Background: Tuberculosis remains a deadly infectious disease, affecting millions of people worldwide. Ethiopia ranks seventh among the twenty two high tuberculosis burden countries. The aim of this study was to determine the prevalence of smear positive pulmonary tuberculosis and its associated risk factors in Goba and Robe hospitals of Bale zone. Methods: A cross-sectional study was conducted on tuberculosis suspected patients from February-May 2012. Sputum samples were examined for acid fast bacilli using Ziehl-Neelsen staining and interview was conducted for each patient. Descriptive statistics, binary logistic and multivariable logistic regression analyses were employed to identify factors associated with pulmonary tuberculosis infection.
BMC infectious diseases, 2017
The real burden of smear-positive (PTB+) and bacteriologically confirmed tuberculosis (BCTB) in Ethiopia is not known. Thus, the aim of this community-based study was to measure the prevalence and incidence of tuberculosis in the Hetosa District of Oromia Region, Ethiopia. First, a population-based cross-sectional survey was conducted on a total of 33,073 individuals aged ≥ 15 years to determine the prevalence of PTB+ and BCTB cases. Then, in order to determine the incidence, a prospective follow-up was carried out on 32,800 individuals found to be either free from symptoms suggestive of TB (SSTB) during the baseline survey or had symptoms suggestive of TB but yielded negative bacteriological examination results. We identified 1,041 presumptive TB cases at the baseline survey, and 1,468 in the follow-up study. Each participants with cough of more than two weeks were provided spot and morning sputum samples for acid-fast bacilli sputum microscopy and culture. At the baseline survey, ...
Journal of medical and biomedical sciences, 2012
There is paucity of data on the prevalence of pulmonary tuberculosis (PTB) among outpatient attendees from individual Institutions and Health Care Facilities performing sputum smear microscopy in Ghana. This retrospective study analyzed sputum smear microscopy results among pulmonary TB suspected patients presenting to the Tamale Teaching Hospital in the Northern Region of Ghana. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2004 to December 2010 were retrieved from the TB Laboratory Register (TB04) of the Bacteriology unit and analyzed. Out of a total of 5,720 registered cases, 4,762 (83.3%) were new patients with suspected pulmonary TB (diagnostic cases). This comprised of 2,766 (58.1%) males and 1,996 (41.9%) females giving a female to male ratio of 1:1.4. Assessment of recorded data for newly suspected pulmonary TB patients rose from a minimum of 165 (9.9%) in 2004 to a maximum of 948 (19.9%) in 2009. Out of a total of the 4,762 recorded new cases, 620 were sputum smear positive yielding positivity rate of 13.0%. The positivity rate on a year-on-year basis was 15.7% (2004), 15.8% (2005), 13.4% (2006), 12.7% (2007), 20.6% (2008), 10.0% (2009) and 6.3% (2010). The median age for recorded smear positive cases was 42 years. Generally the percentage proportion of smear positives in the recorded cases stratified by age showed a steady rise from 0.3% in the <5 year olds and peaked at 16.3% in the 30-35 years age group. A gradual decline in smear positive cases was observed within the 36-41 years age group from 10.0% to 4.8% in the 54-59 years age group from where a gradual rise was observed up to the >72 years age group. There has been a remarkable improvement in diagnostic requests for suspected TB patients. The decline in positivity rates might have been impacted upon greatly by the national strategy to stop TB which emphasized on active case finding and prompt reporting at the community level, improving diagnostic processes and strengthening the health systems. The rapid urbanization and changes in the social fibre of inhabitants cannot be underestimated in the overall TB control efforts.
TB case-finding in southern Ethiopia
Bulletin of the World Health Organization, 2006
Objective To ascertain whether case-finding through community outreach in a rural setting has an effect on case-notification rate, symptom duration, and treatment outcome of smear-positive tuberculosis (TB). Methods We randomly allocated 32 rural communities to intervention or control groups. In intervention communities, health workers from seven health centres held monthly diagnostic outreach clinics at which they obtained sputum samples for sputum microscopy from symptomatic TB suspects. In addition, trained community promoters distributed leaflets and discussed symptoms of TB during house visits and at popular gatherings. Symptomatic individuals were encouraged to visit the outreach team or a nearby health facility. In control communities, cases were detected through passive case-finding among symptomatic suspects reporting to health facilities. Smear-positive TB patients from the intervention and control communities diagnosed during the study period were prospectively enrolled. Findings In the 1-year study period, 159 and 221 cases of smear-positive TB were detected in the intervention and control groups, respectively. Case-notification rates in all age groups were 124.6/10 5 and 98.1/10 5 person-years, respectively (P = 0.12). The corresponding rates in adults older than 14 years were 207/10 5 and 158/10 5 person-years, respectively (P = 0.09). The proportion of patients with >3 months' symptom duration was 41% in the intervention group compared with 63% in the control group (P<0.001). Pre-treatment symptom duration in the intervention group fell by 55-60% compared with 3-20% in the control group. In the intervention and control groups, 81% and 75%, respectively of patients successfully completed treatment (P = 0.12). Conclusion The intervention was effective in improving the speed but not the extent of case finding for smear-positive TB in this setting. Both groups had comparable treatment outcomes.
Archives of Public Health, 2019
Background: In Ethiopia individual report indicated nearly 30% of incident cases of tuberculosis remained undiagnosed. Therefore, this systematic review and meta-analysis was aimed to determine the pooled prevalence rate of undiagnosed smear positive pulmonary tuberculosis (PTB) using community based studies published in Ethiopia. Methods: MEDLINE/PubMed, 'Cochrane' library, and Google scholar databases were searched, and reference list of studies on tuberculosis in Ethiopia were reviewed. We used table to present descriptive information of original studies and quantitative results were presented in forest plots. The Cochrane Q test and I 2 test statistic were used to test heterogeneity across studies. The Pooled prevalence and point estimates of undiagnosed smear positive PTB were computed by a random effects model. From the nine studies included in the analysis, the pooled prevalence rate and point estimate of undiagnosed smear positive PTB was 0.11%(95% CI, 0.06-013%, p < 0.001) and 79.8/100,000(95% CI; 56.3-112.8) respectively. Pooled prevalence rate and point estimate of bacteriologically confirmed PTB were 0.17%(95%CI; 0.13-0.22%, P < 0.001) and 191/100000(95% CI; 141.3-258) respectively. The ratio of active to passive case detection was 2.3(95% CI, 0.42-4.1). Pooled prevalence rate of presumptive PTB was 2.7%(95% CI; 1.3-5.3%). Conclusions: The analysis revealed that the magnitude of undiagnosed smear positive PTB cases in the community is high in Ethiopia. This indicated the ongoing transmission of tuberculosis in community due to missed infectious cases. Active tuberculosis finding in the community should be strengthened in Ethiopia. Trial registration: 140611.