Abstract
Background: TB continues to be a major public health problem in Ethiopia, which ranks eighth by estimated number of cases among the 22 TB high-burden countries. The impact of the programme on treatment outcomes and the trend in the service coverage for tuberculosis has not been assessed ever since. The aim of the study was to assess trends in the expansion of DOTS and treatment outcomes for tuberculosis in Gedeo zone, southern Ethiopia. Methods: 3722 TB patients in Gedeo zone, four health facilities were analysed from September 2009 to August 2014. Data entry was done by EPiData 3.1 and descriptive analysis and multinomial logistic regression modelling for categorical outcome were carried out using STATA version12. Logistic regression is used to model categorical outcome variable, to estimate the relative risk and its corresponding 95% confidence interval. Results were reported as being statistically significant if p-value was less than 5%. Result: Of 3722 patients, 1042 cured (28%), 1431 treatment completed (38.45%), 197 treatment defaulters (5.29%), 161 deaths (4.33%), 12 treatment failures (0.32%) and 879 cases transferred out (23.62%) to other health facilities were recorded in the study. In total, 1,705(45.81%) of the patients were SPPTB, 1,287(34.58%) were SNPTB and the rest 730(19.61%) were EPTB cases. More proportion of death and default were recorded among HIV reactive patients and unknown for their status on HIV test, respectively. Conclusion: TSR of all types of TB patients treated in Gedeo zone health facilities were unsatisfactory (66.44%) compared to the updated Global Plan (WHO, 2011-2015) are to achieve a TSR of 87% by 2015 as a threshold. The proportion of defaulted and failure rates were higher in SPPTB than SNPTB and EPTB but death rate was high in EPTB patients. The health centres exhibited better treatment outcomes compared to hospital.
Highlights
Despite the availability of highly effective treatment for decades, tuberculosis (TB) remains a major global health problem [1]
treatment success rate (TSR) of all types of TB patients treated in Gedeo zone health facilities were unsatisfactory (66.44%) compared to the updated Global Plan (WHO, 2011-2015) are to achieve a TSR of 87% by 2015 as a threshold
The proportion of defaulted and failure rates were higher in SPPTB than SNPTB and Extra-pulmonary TB (EPTB) but death rate was high in EPTB patients
Summary
Despite the availability of highly effective treatment for decades, tuberculosis (TB) remains a major global health problem [1]. One-third of the world’s population is infected with tubercle bacilli and at risk of developing active disease. About 8.4 million people develop active TB and 2.3 million die from the disease. Tuberculosis accounts for 2.5% of the global burden of disease. TB continues to be a major public health problem in Ethiopia, which ranks eighth by estimated number of cases among the 22 TB high-burden countries. The impact of the programme on treatment outcomes and the trend in the service coverage for tuberculosis has not been assessed ever since. The aim of the study was to assess trends in the expansion of DOTS and treatment outcomes for tuberculosis in Gedeo zone, southern Ethiopia
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