Five-year trend analysis of tuberculosis in Bahir Dar, Northwest Ethiopia, 2015–2019

Mengesha, Dagmawi; Manyazewal, Tsegahun; Woldeamanuel, Yimtubezinash

doi:10.4103/ijmy.ijmy_181_21

Cited by 8 publications

(3 citation statements)

References 21 publications

(24 reference statements)

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“…The variation could be due to the difference in the study populations, times and methods. TB was common among the workingage group, which is similar to a study in Bahir Dar, Ethiopia (30).…”

Section: Discussionsupporting

confidence: 87%

Tuberculosis Prevalence and Predictors Among Health Care-Seeking People Screened for Cough of Any Duration in Ethiopia: A Multicenter Cross-Sectional Study

Mohammed

Oljira

Roba

et al. 2022

Front. Public Health

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BackgroundTuberculosis (TB) remains a major cause of morbidity and mortality in sub-Saharan Africa. This high burden is mainly attributed to low case detection and delayed diagnosis. We aimed to determine the prevalence and predictors of TB among health care-seeking people screened for cough of any duration in Ethiopia.MethodsIn this multicenter cross-sectional study, we screened 195,713 (81.2%) for cough of any duration. We recruited a sample of 1,853 presumptive TB (PTB) cases and assigned them into three groups: group I with cough ≥2 weeks, group II with cough of <2 weeks, and group III pregnant women, patients on antiretroviral therapy, and patients with diabetes. The first two groups underwent chest radiograph (CXR) followed by sputum Xpert MTB/RIF assay or smear microscopy. The third group was exempted from CXR but underwent sputum Xpert MTB/RIF assay or smear microscopy. TB prevalence was calculated across the groups and TB predictors were analyzed using modified Poisson regression to compute adjusted prevalence ratio (aPR) with a 95% confidence interval (CI).ResultsThe overall prevalence of PTB was 16.7% (309/1853). Of the positive cases, 81.2% (251/309) were in group I (cough ≥2 weeks), 14.2% (44/309) in group II (cough of <2), and 4.5% (14/309) in group III (CXR exempted). PTB predictors were age group of 25–34 [aPR = 2.0 (95% CI 1.3–2.8)], history of weight loss [aPR = 1.2 (95% CI 1.1–1.3)], and TB suggestive CXRs [aPR = 41.1 (95% CI 23.2–72.8)].ConclusionThe prevalence of confirmed PTB among routine outpatients was high, and this included those with a low duration of cough who can serve as a source of infection. Screening all patients at outpatient departments who passively report any cough irrespective of duration is important to increase TB case finding and reduce TB transmission and mortality.

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Section: Discussionsupporting

confidence: 87%

Tuberculosis Prevalence and Predictors Among Health Care-Seeking People Screened for Cough of Any Duration in Ethiopia: A Multicenter Cross-Sectional Study

Mohammed

Oljira

Roba

et al. 2022

Front. Public Health

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“…Currently, evidence is insufficiently available on the effectiveness of using DHIs to improve TB and HIV management (37)(38)(39)(40)(41). For Ethiopia, where the two diseases are yet the major disease burdens (42)(43)(44)(45), studies on DHIs are desperately needed. Be it in hospitals or health centers, implementation of new DHIs in the study facilities require ICT platforms, dedicated and skilled staffing, leadership support, sustainable financing, and stakeholders engagement.…”

Section: Discussionmentioning

confidence: 99%

Capacity and Readiness Assessment of Healthcare Facilities for Digital Health Interventions Against Tuberculosis and HIV in Addis Ababa, Ethiopia

Getachew

Woldeamanuel

Manyazewal

2022

Front. Digit. Health

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BackgroundThere is a high level of concern that low-income countries lack the capacity and readiness to effectively adopt, implement, and scale up digital health interventions (DHIs). We aimed to assess the infrastructure and human resource capacity and readiness of healthcare facilities to adopt and implement any new DHI for tuberculosis (TB) and HIV care and treatment in Addis Ababa, Ethiopia.MethodWe carried out a cross-sectional, mixed-methods study in 14 public healthcare facilities that provide TB and HIV care and treatment services. Providers' perceived readiness to adopt and implement digital health was assessed using a self-administered questionnaire designed based on an adapted eHealth readiness assessment model that covers six domains: core readiness, organizational cultural readiness, value proposition readiness, technological readiness, regulatory policy readiness, and operational resource readiness. The infrastructure and human resource capacity were assessed on-site using a tool adapted from the Technology Infrastructure Checklist. Internal consistency was assessed using Cronbach's alpha, and the significant relationship between the composite variables was assessed using Pearson's correlation coefficients (r).ResultWe assessed 14 facilities on-site and surveyed 60 TB and HIV healthcare providers. According to Cronbach's alpha test, all the six technology acceptance domains had a value of >0.8, suggesting a strong interrelatedness between the measuring items. The correlation between technological readiness and operational resource readiness was significant (r = 0.8). The providers perceived their work environment as good enough in electronic data protection, while more efforts are needed in planning, training, adapting, and implementing digital health. Of the 14 facilities, 64.3% lack the plan to establish a functional local area network, and 43% lack skilled staff on payroll to provide maintenance of computers and other digital technologies.ConclusionLike many developing countries, there was a modest infrastructure and human resource capacity and readiness of public healthcare facilities in Addis Ababa, Ethiopia, to nurture and strengthen DHIs across the TB and HIV cascades of care. Technological and operational resource readiness, including funding and a Well-trained workforce, are essential for successful implementation and use of digital health against the two infectious diseases of global importance in such settings.

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“…Studies done in Ethiopia reported the prevalence, impact, and molecular epidemiology dynamics of childhood TB [13][14][15][16][17][18][19][20]. However, information is scarce about the potential role and contributions of implementing alternative clinical, radiological, and microbiological TB diagnostic platforms for childhood TB case ndings.…”

Section: Introductionmentioning

confidence: 99%

Patterns of childhood tuberculosis diagnosis in Ethiopia: A multicenter cross-sectional study

Usmael,

Manyazewal,

Mohammed

et al. 2023

Preprint

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Background Children share 12% of the global 10 million people infected with tuberculosis (TB) each year. Closing case detection gap in children remains difficult, with 56% of all children and 65% under-five with TB missed each year. We aimed to assess the patterns of childhood TB diagnosis and underlying determinants in Ethiopia when different TB diagnostic platforms are applied. Methods A multi-site, cross-sectional study was carried out in Ethiopia as part of the larger EXIT-TB study - evidence-based multiple focused integrated intensified TB screening package. Outpatient children aged ≤ 15 with cough of any duration seeking care at four healthcare facilities in Ethiopia were enrolled consecutively. Participants underwent sputum Xpert MTB/RIF and/or smear microscopy and posteroanterior chest X-ray (CXR), and their clinical and sociodemographic data were captured using a structured questionnaire. Data were analyzed using Stata version 23. Multiple regression model was computed to determine the factors that influence TB case detection, with a 95% confidence interval (CI) and p < 0.05 taken as statistically significant. Results A total of 438 children were enrolled. Of these, 399 had CXR examination of which 55 (13.8%) were suggestive of TB, 270 had Xpert MTB/RIF testing of which 32 (11.9%) were positive, and AFB smear microscopy was done for 51 children of which 2 (3.9%) were positive. Febrile children were more likely to be diagnosed with pulmonary TB than those without fever [aPR = 1.3, 95% CI (1.1–1.4)], and those with a TB contact history were more likely to be diagnosed with pulmonary TB than those with no such contacts [aPR = 1.2, 95% CI (1.1–1.3)]. Children from rural residences were more likely to be diagnosed with TB than those from urban residences [aPR = 1.3, 95% CI (1.1–1.5)]. Conclusion The findings showed that clinical diagnosis remains an important method of TB diagnosis in children and the preferred choice to avert underdiagnosis. A more sensitive TB diagnostic method for children was symptom screening, followed by CXR and Xpert MTB/RIF assay or smear microscopy. Hence, an algorithm that combines clinical, CXR, and microbiological confirmatory tests can improve the rate of pulmonary TB diagnosis in children till more accurate and cost-effective diagnostic tools are accessible. Fever, weight loss, and TB contact history are highly associated with TB positivity rates in children.

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Five-year trend analysis of tuberculosis in Bahir Dar, Northwest Ethiopia, 2015–2019

Cited by 8 publications

References 21 publications

Tuberculosis Prevalence and Predictors Among Health Care-Seeking People Screened for Cough of Any Duration in Ethiopia: A Multicenter Cross-Sectional Study

Tuberculosis Prevalence and Predictors Among Health Care-Seeking People Screened for Cough of Any Duration in Ethiopia: A Multicenter Cross-Sectional Study

Capacity and Readiness Assessment of Healthcare Facilities for Digital Health Interventions Against Tuberculosis and HIV in Addis Ababa, Ethiopia

Patterns of childhood tuberculosis diagnosis in Ethiopia: A multicenter cross-sectional study

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