Abstract
BackgroundTuberculosis (TB) is a major problem in developing countries. TB in Egypt is considered an important public health problem. Egypt is ranked among the mid-level incidence countries.ObjectiveTo evaluate TB status in 19 governorates and to compare the TB situation in Upper and Lower Egypt over 20 years from 1992 to 2012 before and after the application of directly observed treatment short-course strategy (DOTS).Patients and methodsThis is a retrospective study involving record review. The registered data were collected from TB registration units in the 19 governorates.ResultsThe highest percentage of TB cases was in the age group 15–30 years. Infection was higher in males than females and in rural areas more than urban areas. Pulmonary TB and smear positivity at diagnosis, second, third, and fifth month were higher in Lower Egypt. Treatment after failure or relapse was significantly higher in Upper Egypt, whereas default rate, failure rate, and death rate were significantly higher in Lower Egypt. Regarding treatment outcome, cure, complete treatment, and transfer out were significantly increased after DOTS than before. Failure, default, and death were significantly reduced after DOTS than before DOTS. Upper Egypt included higher incidence rates of TB, new adult smear-positive cases, new extrapulmonary TB cases, and sputum conversion rate at the end of the initial phase of treatment. Cure rate and treatment success rate were significantly higher among patients of Upper Egypt, whereas transfer out rate and retreatment failure rate were significantly higher among Lower Egypt patients.ConclusionTB is still a health problem in Egypt, with pulmonary TB more in Lower Egypt, whereas extrapulmonary more in Upper Egypt, but after the introduction of DOTS, there is a significant increase in cure and success rate, with markers of success being more in Upper Egypt.
Highlights
Tuberculosis (TB) is one of the major public health threats, competing with the HIV as the cause of death owing to infectious diseases worldwide [1]
Treatment after failure or relapse was significantly higher in Upper Egypt, whereas default rate, failure rate, and death rate were significantly higher in Lower Egypt
Cure rate and treatment success rate were significantly higher among patients of Upper Egypt, whereas transfer out rate and retreatment failure rate were significantly higher among Lower Egypt patients
Summary
Tuberculosis (TB) is one of the major public health threats, competing with the HIV as the cause of death owing to infectious diseases worldwide [1]. According to the WHO, nearly 8.6 million cases were estimated to have occurred in 2012. Most cases are estimated to be in Asia and Africa (58 and 27%, respectively) [2]. Near the end of the 20th century, TB prevention and care in Egypt faced numerous issues. The most significant of these issues were the rejection of the patients with TB to be hospitalized for their management, high lost follow-up rate, rising levels of resistance against anti-TB drugs, and inadequate health education to both general population and healthcare workers [3]. Major progress in TB prevention and care followed the widespread implementation of directly observed treatment short-course (DOTS) strategy. Tuberculosis (TB) is a major problem in developing countries. TB in Egypt is considered an important public health problem.
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