Evaluation of the National Tuberculosis Surveillance System in Sana’a, Yemen, 2018: Observational Study

kalali, Fadwa Salem Ahmed Al; Mahyoub, Essam; Anam, Labiba; Khader, Yousef

doi:10.2196/27626

Cited by 5 publications

(5 citation statements)

References 9 publications

(25 reference statements)

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“…The TB Surveillance System faces notable gaps and issues regarding data quality and analysis. This finding is consistent with the findings of other studies 33 , 34 but inconsistent with the findings of other studies. 35 , 36 Without meaningful data to inform public health action, Jordan is likely to fall short of its goal of eliminating TB.…”

Section: Discussionsupporting

confidence: 72%

“…In other countries, some studies reported poor ratings of the simplicity of the system for several reasons including data collection is time-consuming and report forms are not easy to fill. 3 , 34 , 37 However, other studies in Yemen, Pakistan, and South Africa 35 , 39 , 40 reported that the system is simple. On the other hand, flexibility was rated good with some updates that need to be reflected in the dataset.…”

Section: Discussionmentioning

confidence: 96%

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Evaluation of the National Tuberculosis Program and Tuberculosis Surveillance System, Jordan 2021

Khader,

Al-Rahamneh,

Abu Khudair

et al. 2024

SAGE Open Medicine

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Objectives: Evaluate and determine the gaps in the National Tuberculosis Program and Tuberculosis Surveillance System in Jordan. Methods: A concurrent embedded mixed quantitative/qualitative methods study was conducted to assess the National Tuberculosis Program and Tuberculosis Surveillance System in Jordan. A semi-structured questionnaire was developed based on the Updated CDC Guideline for Evaluating Public Health Surveillance System to collect necessary information from service providers and other stakeholders. Results: The National Tuberculosis Program and Tuberculosis Surveillance System encounter various gaps and challenges across several critical domains, including infrastructure, human resources, National Tuberculosis Program functions, surveillance system performance, coordination, case findings, and data collection and notification. Regrettably, not all of the Tuberculosis Surveillance System’s objectives were successfully achieved in the past. Coordination of tuberculosis services has been repeatedly reported as inadequate. This deficiency manifests in the delay in diagnosing tuberculosis patients and, in some instances, misdiagnoses. The root cause is often traced back to insufficient knowledge of tuberculosis case definitions among healthcare providers at peripheral tuberculosis clinics. Additionally, a structured approach to active case finding is conspicuously absent. Furthermore, the tuberculosis management guidelines remain unfamiliar to many healthcare providers in tuberculosis centers, leaving them inadequately equipped to handle tuberculosis cases effectively. The utilization and analysis of the system’s data are also far from optimal. A glaring concern is the delay in tuberculosis case notifications received from the stakeholders involved in the Tuberculosis Surveillance System. Conclusions: Our study showed different gaps in the National Tuberculosis Program and Tuberculosis Surveillance Systems across several areas. The structure of National Tuberculosis Program and the clinical expertise of human resources do not support tuberculosis elimination. An electronic data collection and notification system is essential to facilitate tuberculosis case detection, reporting, and follow-up. Decision-makers should push the tuberculosis epidemic on the national health agenda. Jordan should focus on allocating national and international resources for tuberculosis control programs.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 96%

Evaluation of the National Tuberculosis Program and Tuberculosis Surveillance System, Jordan 2021

Khader,

Al-Rahamneh,

Abu Khudair

et al. 2024

SAGE Open Medicine

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“…TB remains a major public health problem in developing countries such as Yemen, where NTP is the main health entity that deals with active TB cases. Before the outbreak of the civil war, the NTP budget was provided by international donors to the ministry of public health and population to cover NTP activities across the country [4]. However, as of 2015, the International Organization for Migration (IOM) has become the intermediary between international donors and the NTP in Yemen.…”

Section: Discussionmentioning

confidence: 99%

“…According to the WHO estimates, 14,700 TB patients were reported in Yemen in 2020, with an incidence rate of 49/100,000 people and a mortality rate of 7.3.100,000 people [3]. It should be noted that the only source of data on the number of TB cases in the country is the National TB Program (NTP), which was established in 1970 [4]. Due to the civil war, Yemen currently suffers from poverty and social unrest, which are factors that seriously affect TB infection rates.…”

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confidence: 99%

Prevalence of tuberculosis in Shabwah Governorate, Yemen: A cross-sectional study

Hezam¹,

Humaidah²

2022

Yemen J Med

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Background: There is a lack of data on current tuberculosis (TB) burden in Shabwah Governorates in Yemen. This study aimed to investigate the prevalence, epidemiology, and outcomes of TB disease in Shabwah Governorate, Yemen. Materials and Methods: This cross-sectional study was conducted at the National TB Program (NTP) Center in Ataq City, Shabwah Governorate, Yemen. The study involved TB patients of different ages who were notified at the center between January 1, 2021, and December 31, 2021. Results: We involved a total of 123 new active TB cases, including 86 (69.9%) with pulmonary TB (PTB) and 37 (30.1%) with extrapulmonary TB (EPTB). The total prevalence of TB disease during the year 2021 was 14.5 new TB cases per 100,000 population, while the median age of the study population was 34 years. The majority of the cases (23.6%) belonged to age group 15–24 years. There was a slightly higher preponderance of males 54.5% (n=67). EPTB was detected in 37 (30.1%) patients with lymph node TB being the most common manifestation [17 (46.0%)]. All patients received four-drug anti-TB therapies for 6–12 months. Most patients 111 (90.3%) were cured, and 2 (1.6%) patients died during the course of the disease, while 10 (8.1%) patients were lost during follow-up. Conclusion: The prevalence of TB in Shabwah Governorate was 14.5/100,000 population. Male patients and younger age groups were more affected, while the lymph nodes were the main extrapulmonary sites involved and the cure rate was 90.2%. The results of the study indicate the need to revise the notification form for active TB cases and to expand NTP activities to focus on targeted screening for active TB cases in high-risk groups to close the gap in unidentified TB cases.

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“…In 1970, the National Tuberculosis Control Program (NTCP) was established in Yemen to implement strategies and policies related to the control, treatment, and prevention of tuberculosis, including the World Health Organization (WHO) End Tuberculosis Strategy. In addition, the NTCP has adopted the directly observed therapy (DOT) Strategy since 1995 and expanded it gradually until full coverage in all the TB units in Yemen was realized [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Recurrence Rate of Pulmonary Tuberculosis in Patients Treated with the Standard 6-Month Regimen: Findings and Implications from a Prospective Observational Multicenter Study

Anaam

Alrasheedy

2023

TropicalMed

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Tuberculosis (TB) recurrence following successful treatment is a significant challenge in TB control programs. However, the rate of TB recurrence varies among studies. It depends on several factors, including the country/region where the investigation occurs, the study design, sample characteristics, and the anti-TB regimen used. In Yemen, a few previous studies examined the rate of TB recurrence and reported high recurrence rates, with a 5-year recurrence rate of approximately 9.5%. However, they were conducted before 2010 using the previous anti-TB regimen which was phased out and replaced with the World Health Organization’s (WHO) standard 6-month TB regimen. Consequently, this study aimed to examine the rate of TB recurrence after the implementation of the WHO standard 6-month regimen in Yemen. A prospective observational study was conducted with patients diagnosed with drug-susceptible pulmonary TB. The patients were recruited from five health centers with TB units in five governorates from January to December 2011. All the patients were followed up for five years after treatment completion. A total of 439 patients who completed the anti-TB regimen met the inclusion criteria and were included in the study. During the 5-year follow-up period, 8 patients (1.8%) died, and 13 patients (2.96%) were lost to follow-up, resulting in a final cohort of 418 patients. Of the cohort, 50.5% (n = 211) were male, while 49.5% (n = 207) were female patients. Of the patients, 129 patients (30.9%) were illiterate, 56 (13.4%) had cavitary pulmonary disease, and 6.2% (n = 26) had diabetes. The overall 5-year rate of TB recurrence in this study for the patients receiving the standard 6-month regimen was 2.9% (12/418). Moreover, almost half of the recurrent cases (41.7%; n = 5) were seen during the first year of the follow-up period. Some patient groups with risk factors recorded a higher recurrence rate, including patients with diabetes (15.4%), non-compliant patients (14.3%), pre-treatment lung cavitation patients (8.9%), illiterate patients (7.8%), and underweight patients (5.1%). In conclusion, the overall TB recurrence rate with the standard 6-month regimen was lower than that with the previous TB regimens. However, more efforts are needed to decrease TB recurrence rates further and achieve a durable cure for TB. In addition, healthcare professionals and TB control programs should consider potential risk factors of recurrence and address them to provide optimal care.

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Evaluation of the National Tuberculosis Surveillance System in Sana’a, Yemen, 2018: Observational Study

Cited by 5 publications

References 9 publications

Evaluation of the National Tuberculosis Program and Tuberculosis Surveillance System, Jordan 2021

Evaluation of the National Tuberculosis Program and Tuberculosis Surveillance System, Jordan 2021

Prevalence of tuberculosis in Shabwah Governorate, Yemen: A cross-sectional study

Recurrence Rate of Pulmonary Tuberculosis in Patients Treated with the Standard 6-Month Regimen: Findings and Implications from a Prospective Observational Multicenter Study

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