Our study indicates a significant decline in malaria morbidity and mortality in the islands of Moheli, Anjouan and Grand Comoro from 2010 to 2014. This considerable reduction is attributed to a combination of malaria prevention and control interventions implemented during the study period.

Aim This study evaluated the underlying factors associated with poor tuberculosis (TB) treatment outcomes among patients attending health care facilities in Galkayo, Puntland, Somalia. Methods An institution-based cross-sectional study was conducted between 2016 and 2017 in three selected TB clinics. Data were collected from 400 TB patients, through medical record review and structured questionnaire. Multivariate logistic regression analyses were performed. Results Of the 400 TB respondents, 57.3% were new cases, 12.3% had smear-negative TB and 12.5% had extrapulmonary TB. The median age was (35.66 ± 13.16) with majority being male (65.5%). Overall, 85% of patients were successfully treated, 9.7% failed and 5.3% defaulted. Multivariate analysis revealed that patient’s body weight (odds ratio [OR]: 1.078); diabetes (OR: 8.022); family size (OR: 3.851); patients’ delay in diagnosis (OR: 11.946); frequency of receiving anti-TB medication (OR: 9.068); smoker (OR: 5.723); category of patients (retreatment versus new, OR: 5.504; retreatment versus transfer in, OR: 4.957); health facilities (OR: 6.716) and treatment duration (OR: 132.091) were independent factors associated with poor TB outcomes. Conclusions Our findings highlight the need to improve TB services for vulnerable groups. They also emphasize the need for health system strengthening, public awareness and risk of treatment interruption. This may reduce both patients’ delay in seeking care and TB treatment failure in Galkayo district.

This paper highlights the availability, pricing and affordability of popular medicines in Comoros. We used the standardized survey methodology developed by the World Health Organization and Health Action International to conduct a cross sectional survey for collecting data on availability and patient prices of medicines in public, private and mission sector medicines outlets from April 1 to June 30, 2014. Median availability of medicines in Comoros across all sectors was particularly low at 31.11% for all product types. The median price ratios of procurement prices for original brands, most sold generics and lowest-priced generics in the public sector, were 11.60, 4.74 and 3, respectively. These were 83 times higher than the international reference prices; and the median price ratios of retail prices to patients for lowest priced generics in the private sector were 29.49% higher than those in the public sector. For most of the population, the medicine prices are unaffordable particularly in the islands Ndzuwani and Mwali, where many people earn less 1$ per day. The survey revealed higher procurement prices and poor availability in the public sector. Various policy adjustments could increase the availability of essential medicines and reduce their prices for the low income population.

The purpose of this paper is two-fold. First, to give an overview of the size and measure trends in health inequalities in the Comoros islands (Comoros) since 1996. Second, to assess the wide differences in health and health care across rural/urban areas and islands in Comoros, by using available and comparable leading indicators, in order to promote regular monitoring of policy goals. This assessment is aimed at reducing health inequalities and providing adequate or equal access to health care between islands. Data from the Demographic and Health Survey, Multiple Indicators Cluster Surveys from 1996, 2000 and 2012, the World Health Organization, the World Bank, the African Development Bank data sources, were analyzed for a population health-oriented approach characterized by measuring health differences from the population average, taking account of the population size of the social groups on both relative and absolute scales. The results showed that there exist geographic disparities in health in Comoros, mainly in maternal and child health.