Tuberculosis Burden in Ethiopia from 1990 to 2016: Evidence from the Global Burden of Diseases 2016 Study.

Amare Deribew,Scott D Glenn,Awoke Misganaw,Azmeraw T Amare,Semaw F Abera,Tolessa Bekele,Yihune Lakew,Yohannes Adama Melaku,Gizachew Assefa Tessema,Andargachew Kumsa,Hmwe Kyu,Sibhatu Biadgilign,Yibeltal Assefa,Tariku Dejene,Kebede Deribe,Muluken Dessalegn

doi:10.4314/ejhs.v28i5.2

Abstract

The burden of Tuberculosis (TB) has not been comprehensively evaluated over the last 25 years in Ethiopia. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk Factors (GBD) data to analyze the incidence, prevalence and mortality rates of tuberculosis (TB) in Ethiopia over the last 26 years. The GBD 2016 is a mathematical modeling using different data source for Ethiopia such as verbal autopsy (VA), prevalence surveys and annual case notifications. Age and sex specific causes of death for TB were estimated using the Cause of Death Ensemble Modeling (CODEm). We used the available data such as annual notifications and prevalence surveys as an input to estimate incidence and prevalence rates respectively using DisMod-MR 2.1, a Bayesian meta-regression tool. In 2016, we estimated 219,186 (95%UI: 182,977-265,292) new, 151,602 (95% UI: 126,054-180,976) prevalent TB cases and 48,910(95% UI: 40,310-58,195) TB deaths. The age-standardized TB incidence rate decreased from 201.6/100,000 to 88.5/100,000 (with a total decline of 56%) between 1990 to 2016. Similarly, the age-standardized TB mortality rate declined from 393.8/100,000 to 100/100,000 between 1990 and 2016(with a total decline of 75%). Ethiopia has achieved the 50% reduction of most of the Millennium Development Goals (MDGs) targets related to TB. However, the decline of TB incidence and prevalence rates has been comparatively slow. The country should strengthen the TB case detection and treatment programs at community level to achieve its targets during the Sustainable Development Program (SDGs)-era.

Highlights

The United Nations General Assembly endorsed the historical resolution of the Millennium Development Goals (MDG) in 2000
Ethiopia has achieved the 50% reduction of most of the Millennium Development Goals (MDGs) targets related to TB
Other reports show that Ethiopia has achieved most of the MDG targets related to TB (1820)

Summary

Introduction

The United Nations General Assembly endorsed the historical resolution of the Millennium Development Goals (MDG) in 2000. We used the Global Burden of Disease Study (GBD) 2016 data [7,8,9,10,11] to assess the mortality, incidence, prevalence and Disability-adjusted Life Years Lost (DALY) rates of TB over the last 26 years. The rationale of using the GBD data include: i) GBD modeling strategy provides nationally representative estimates which cannot be obtained through small scale studies or surveys; ii) GBD uses standard modeling approach globally and our finding (Ethiopian performance) can be compared with others who are using GBD; iii) The study provides evidence on the achievement of Ethiopia on the MDG targets and the findings will serve as a baseline for future tracking of TB targets. We used the 2016 Global Burden of Diseases, Injuries and Risk Factors (GBD) data to analyze the incidence, prevalence and mortality rates of tuberculosis (TB) in Ethiopia over the last 26 years.

Methods

Results

Conclusion