Correction: Trends of Tuberculosis Case Notification and Treatment Outcomes in the Sidama Zone, Southern Ethiopia: Ten-Year Retrospective Trend Analysis in Urban-Rural Settings

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doi:10.1371/journal.pone.0125135

Cited by 4 publications

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“…The average treatment failure rate of 0.2% in this study is consistent with 0.2% (95% CI: 0.19%, 0.20%) by Mesay et al (23), 0.4% (95% CI: 0.26%, 0.59%) by Belete et al (24), 0.5% (95% CI: 046%, 0.53%) by Fantahun et al (25), and 0.5% (95% CI: 0.49%, 0.51) by Shallo et al (15). The lower treatment failure in this study could be related to the higher smear conversion rate of smear-positive pulmonary TB at the end of the intensive treatment phase which is the single most significant predictor of the TB treatment failure (26) that could also be potentially linked to the low drug resistance rate in the area (27).…”

Section: Discussionsupporting

confidence: 92%

Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data

Tafess

Beyen²,

Abera

et al. 2018

Front. Med.

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BackgroundDirectly Observed Treatment Short-course (DOTS) has been one of the major strategies to combat the epidemic of tuberculosis (TB) globally. This study aimed to evaluate TB treatment outcomes between September 2004 and July 2014 under the DOTS program at one of the largest public hospitals in Ethiopia.MethodsA retrospective data of TB patients registered at Asella Teaching Hospital between September 2004 and July 2014 were obtained from hospital registry. Treatment outcomes and types of TB cases were categorized according to the national TB control program guideline. Binomial and multinomial logistic regression models were used to analyze the association between treatment outcomes and potential predictor variables.ResultsA total of 1,755 TB patients’ records were included in the study. Of these, 945 (53.8%) were male, 480 (27.4%) smear-positive TB, 287 (16.4%) HIV positive, and 1,549 (88.3%) new cases. Among 480 smear-positive pulmonary TB cases, 377 (78.5%) patients were cured, 21 (4.40) completed the treatment, 35 (7.3%) transferred out, 19 (4.0%) died, 24 (5.0%) defaulted, and 4 (0.8%) failure. Overall, 398 (82.9%) smear-positive pulmonary TB patients were successfully treated. For smear-negative TB (n = 641) and extrapulmonary TB cases (n = 634), 1,036 (81.3%) completed the treatment and demonstrated favorable response. Taking all TB types into account, 1,434 (81.7%) were considered as successfully treated. In the multivariate binary logistic model, patients in older age group (AOR = 0.386, 95% CI: 0.250–0.596) and retreatment cases (AOR = 0.422, 95% CI: 0.226–0.790) were less likely to be successfully treated compared to younger and new cases, respectively. In multinomial logistic regression, age increment by 1 year increased the risk of death and default of TB patients by 0.05 (adjusted β = 0.05; 95% CI: 0.03, 0.06) and 0.02 (adjusted β = 0.02; 95% CI: 0.01, 0.04). The odds of TB patients who died during treatment were higher among HIV-infected TB patients (adjusted β = 2.65; 95% CI: 1.28, 5.50).ConclusionThe treatment success rate of TB patients was low as compared to the national target. TB control needs to be strengthened for the enhancement of treatment outcome.

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Section: Discussionsupporting

confidence: 92%

Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data

Tafess

Beyen²,

Abera

et al. 2018

Front. Med.

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“…The global gender difference in the TB notification was also found within the two study populations [ 1 ], where most patients were male in the SCs and female in refugees, with yielding a male to female ratio of 1.39:1 and 1:1.18 among SCs and refugees, respectively. This high TB notification in male among the SCs supports previous studies in Ethiopia [ 14 – 16 ]. Similarly, the presence of more TB patients in female among refugees supports previous study in Pakistan [ 17 ].…”

Section: Discussionsupporting

confidence: 89%

“…The study also revealed a gradual increase in all forms of TB in refugees that contrast with the trend in the SCs in the present and other studies [ 14 – 16 , 20 ]. This is attributed to the increasing number of refugee population in the study refugee camps following political instability in South Sudan since 2013 [ 13 ] and degradation of health care system in the home country that imposes a negative impact on TB diagnosis, treatment and prevention efforts.…”

Section: Discussioncontrasting

confidence: 70%

“…Similarly, the presence of more TB patients in female among refugees supports previous study in Pakistan [ 17 ]. This gender inequality between refugees and the SCs as well as other previous studies [ 14 – 17 ] could be due to differences in biological, socio-economic, cultural and access to health facilities [ 17 – 19 ]. The presence of narrow difference in gender ratio was attributed to an improvement in the access to TB control services in the area [ 14 ].…”

Section: Discussionmentioning

confidence: 72%

“…The occurrences of a higher PTB+ in refugees and PTB- in the SCs found in this study could be attributed to the differences in socioeconomic status [ 21 ], living conditions [ 22 ], and prevalence of HIV/AIDS [ 14 ] between the two population as refugees were more likely to be nutritionally poor, live in crowded conditions [ 23 ] and have high (31.22%) TB/HIV co-infection.…”

Section: Discussionmentioning

confidence: 96%

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Factors associated with unsuccessful treatment outcome in tuberculosis patients among refugees and their surrounding communities in Gambella Regional State, Ethiopia

et al. 2018

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BackgroundTuberculosis (TB) is a leading cause of public health challenges among immigrant refugees and their surrounding communities in developing countries. Evaluating the treatment outcome of TB patients is one of the key indicators to understand the performance of TB control program. Hence, this study aims to assess profile, treatment outcome and factors associated with unsuccessful outcome of TB patients treated under the TB control program among refugees and their surrounding communities (SCs) in Gambella Regional State, Ethiopia.MethodologyRetrospective study was conducted in the health facilities of refugee and their SCs in Gambella Regional State from March 1 to May 30, 2017. Demographic and related data of all TB patients registered in TB Control Program between September, 2008 and October, 2017 in health facilities of refugee and the SCs was extracted using data extraction format. Eight years trend of TB, treatment outcome and factors associated with unsuccessful outcome among refugees and the SCs were computed using SPSS version 20.0 software.ResultA total of 886 refugees and 3284 SCs TB patients, registered for anti TB treatment in the last eight years, were evaluated in the study. The trend of all forms of TB is progressively increasing among refugees contrary to the SCs in the course of the study period (X2 trend = 207.7; P<0.0001). Smear positive pulmonary TB (PTB+) was found to be predominant (57.6%) TB form in refugees while smear negative pulmonary TB (PTB-) (44.8%) is in the SCs (X2 = 185.834; P<0.0001). There was also significant difference in the treatment outcome (X2 = 170.915; P<0.0001). Mean treatment success rate was 74.2% and 88.1% for refugees and the SCs, respectively (X2 = 92.887; P<0.0001). The study also revealed that the risk of unsuccessful TB treatment outcome was significantly higher among refugee (AOR = 2.17; 95% CI: 1.69–2.77), retreated cases (AOR = 1.53; 95% CI: 1.07–2.17), patients aged between 35–44 years (AOR = 1.38; 95% CI: 1.0–1.91), and greater than 44 years old (AOR = 1.77; 95% CI: 1.28–2.44), and patients with extra pulmonary TB (EPTB) form (AOR = 1.34; 95% CI: 1.04–1.73) compared to their counterparts. Patient coming from rural area (AOR = 0.77; 95% CI: 0.62–0.97), who are female (AOR = 0.76; 95% CI: 0.63–0.91) and TB/HIV non-infected (AOR = 0.63; 95% CI: 0.51–0.77) were more likely to be successfully treated.ConclusionThe study confirmed that there was low treatment success rate among refugees compared to the SCs. Being refugee, retreated case, patient’s age ≥35 years old, EPTB form, gender, rural patient address and HIV status were predictor factors for unsuccessful treatment outcome. Hence, the study urges the need for strengthened TB prevention program among refugees with due consideration of identified predictor factors to prevent the potential effect of hosting refugee to the SCs and the nations at large.

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Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017

Legesse

Admenur²,

Gebregzabher³

et al. 2021

BMC Infect Dis

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Background Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. Results A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2 to 32.7%), in contribution of children to total TB cases (18.8 to 30.1%) and to EPTB (40.6 to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8 to 64.8%). Treatment success rates for all TB cases remained lower at 72.7–79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. Conclusions There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (> = 90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Correction: Trends of Tuberculosis Case Notification and Treatment Outcomes in the Sidama Zone, Southern Ethiopia: Ten-Year Retrospective Trend Analysis in Urban-Rural Settings

Cited by 4 publications

References 1 publication

Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data

Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data

Factors associated with unsuccessful treatment outcome in tuberculosis patients among refugees and their surrounding communities in Gambella Regional State, Ethiopia

Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017

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