Abstract
BackgroundThe 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.MethodsA 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.ResultsThe 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.ConclusionsThe 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.
Highlights
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
We reviewed the profile of all forms of TB cases registered between September 1, 1997 and August 31, 2011 to analyze the trends in TB case notification and make compression of TB performance across districts in Arsi Zone of Oromia Regional State, Central Ethiopia
The Trends in Directly Observed Treatment Short course (DOTS) Site Expansion and TB Case Notification The trend in TB case notification was significantly associated with the number of DOTS sites in the zone (Figure 1a and 1b, X2trend = 75.2, P < 0.001) which gradually increased from five in 1997 to 23 in 2001 and from 46 in 2007 to 74 in 2011 (Figure 1b)
Summary
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. Despite the availability of effective treatment since the mid-1990s, TB remains a major public health problem and the second leading cause of death worldwide [1,2,3]. In 2011 there were about 8.7 million new TB cases and 1.4 million deaths worldwide from the disease [4]. Observed Treatment Short course (DOTS) as a standard strategy to control the disease [5,6]. DOTS aim to detect 70% of infectious cases and successfully treat. TB is one of the most important infectious diseases responsible as 3rd cause of hospital admission and the second top causes of death in Ethiopia [3,8]. According to the 2011 national TB survey result, the prevalence of all forms of TB was 240 and PTB + was 108 per
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