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

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 uns...

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Autores principales: Legesse, Tsegay, Admenur, Goitom, Gebregzabher, Selemawit, Woldegebriel, Eyob, Fantahun, Bexabeh, Tsegay, Yemane, Bayssa, Abeyot, Darge, Berihu, Denbu, Yidnekachew, Michalel, Hayelom, Abera, Kibebew, Alemayeh, Abraham, Kebede, Dejene, Kasa, Desta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856765/
https://www.ncbi.nlm.nih.gov/pubmed/33535974
http://dx.doi.org/10.1186/s12879-021-05828-y
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author Legesse, Tsegay
Admenur, Goitom
Gebregzabher, Selemawit
Woldegebriel, Eyob
Fantahun, Bexabeh
Tsegay, Yemane
Bayssa, Abeyot
Darge, Berihu
Denbu, Yidnekachew
Michalel, Hayelom
Abera, Kibebew
Alemayeh, Abraham
Kebede, Dejene
Kasa, Desta
author_facet Legesse, Tsegay
Admenur, Goitom
Gebregzabher, Selemawit
Woldegebriel, Eyob
Fantahun, Bexabeh
Tsegay, Yemane
Bayssa, Abeyot
Darge, Berihu
Denbu, Yidnekachew
Michalel, Hayelom
Abera, Kibebew
Alemayeh, Abraham
Kebede, Dejene
Kasa, Desta
author_sort Legesse, Tsegay
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-05828-y.
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spelling pubmed-78567652021-02-04 Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017 Legesse, Tsegay Admenur, Goitom Gebregzabher, Selemawit Woldegebriel, Eyob Fantahun, Bexabeh Tsegay, Yemane Bayssa, Abeyot Darge, Berihu Denbu, Yidnekachew Michalel, Hayelom Abera, Kibebew Alemayeh, Abraham Kebede, Dejene Kasa, Desta BMC Infect Dis Research Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-05828-y. BioMed Central 2021-02-03 /pmc/articles/PMC7856765/ /pubmed/33535974 http://dx.doi.org/10.1186/s12879-021-05828-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Legesse, Tsegay
Admenur, Goitom
Gebregzabher, Selemawit
Woldegebriel, Eyob
Fantahun, Bexabeh
Tsegay, Yemane
Bayssa, Abeyot
Darge, Berihu
Denbu, Yidnekachew
Michalel, Hayelom
Abera, Kibebew
Alemayeh, Abraham
Kebede, Dejene
Kasa, Desta
Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
title Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
title_full Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
title_fullStr Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
title_full_unstemmed Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
title_short Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
title_sort tuberculosis (tb) in the refugee camps in ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856765/
https://www.ncbi.nlm.nih.gov/pubmed/33535974
http://dx.doi.org/10.1186/s12879-021-05828-y
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