Abstract
BackgroundDespite the existence of national tuberculosis guidelines (NTG) in Ethiopia, the incidence and prevalence of tuberculosis did not decline markedly. Audits could attempt to determine whether or not healthcare professionals actually implemented these guidelines, as non-implementation could contribute to suboptimal tuberculosis treatment outcomes.AimTo evaluate healthcare providers’ implementation of Ethiopia's NTG during the diagnosis and treatment of tuberculosis in order to enhance tuberculosis treatment outcomes.MethodsA descriptive, cross-sectional study design was used.ResultsHealthcare providers implemented the NTG during tuberculosis diagnosis for female (60.9%; n = 67) and male (56.1%; n = 69) patients. The correct numbers of anti-tuberculosis pills, complying with the NTG recommendations, were prescribed for 91.8% (n = 101) of the women and for 90.2% (n = 111) of the men. However, both over- and under-prescriptions of anti-tuberculosis drugs occurred. There was an over-diagnosis of smear-negative pulmonary tuberculosis. Only 2.6% (n = 2) of the 76 smear-negative pulmonary tuberculosis patients had been diagnosed correctly.ConclusionImplementation of the NTG should be enhanced, especially with regard to the diagnosis of smear-negative pulmonary tuberculosis patients and the correct prescription of anti-tuberculosis drugs. This would help to increase the number of correctly-diagnosed and -treated tuberculosis patients, improve tuberculosis treatment outcomes, decrease the spread of tuberculosis and prevent the development of multi-drug-resistant tuberculosis strains.
Highlights
Tuberculosis (TB) poses major public health challenges and its incidence continues to increase in many parts of the world, especially in countries in sub-Saharan Africa (SSA)
The aim of this study was to assess implementation of the national tuberculosis guidelines (NTG) by healthcare providers during diagnosis and treatment of TB patients; to recommend ways to improve TB treatment outcomes; and to reduce the number of patients suffering from TB and multi-drug resistant TB (MDR-TB)
Presenting complaints were recorded in 91% (n = 212), but the TB diagnoses had only been recorded in 9% (n = 21) of these patients’ medical files
Summary
Tuberculosis (TB) poses major public health challenges and its incidence continues to increase in many parts of the world, especially in countries in sub-Saharan Africa (SSA). Based on estimates by the World Health Organization[1] (WHO), 9.27 million new TB cases (139 per 100 000 population) were diagnosed globally during 2007. Most countries have implemented the internationally-recommended directly-observed treatment short course strategy (DOTS), SSA continued to report high TB incidence and prevalence rates. Thirteen of the 15 countries with the highest estimated global TB incidence are in Africa.[1] Limited healthcare seeking behaviours on the part of the patients and shortages of healthcare professionals contribute to the TB prevalence rates in Africa.[2]. Audits could attempt to determine whether or not healthcare professionals implemented these guidelines, as non-implementation could contribute to suboptimal tuberculosis treatment outcomes
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