Five-year Trend Analysis of Tuberculosis Burden in Bahir Dar, Northwest Ethiopia, 2015 - 2019
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Date
2021-07
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Addis Ababa University
Abstract
Background: Tuberculosis (TB) remains a major cause of morbidity and mortality in Ethiopia despite the increased availability of effective treatments. Trend analysis of issues and priorities affecting TB programs across different regions of the country is critical to ensure equitable and sustainable TB outcomes.
Objective: The study aimed to determine the trends of TB burden in Bahir Dar,
Northwest Ethiopia, for five years from 2015 to 2019.
Methods: An institution-based retrospective study was conducted. Five-year data and records of individual cases screened for TB were reviewed from all government- and private-led healthcare facilities that implemented DOTs programs in Bahir Dar (N = 47) from January 1, 2015 to December 30, 2019. Data were collected with a data collection format adopted from the standard checklist of World Health Organization. The checklist contains unique code, age, sex, residence, HIV status, and year of diagnosis of subjects.
First we categorized participants data and records based on their age as (<15, 15-24, 2534, 35-44, 45-65 and 65+), Sex (male/female), the type of TB infection (PTB+, PTB- and EPTB) and the years of diagnosis (2015, 2016, 2017, 2018 and 2019). A standard checklist was used to collect data relevant to screening, diagnosis, and treatment of TB. SPSS version 20 software was used for data analysis. Descriptive analysis, frequencies, and figures were used to explain the findings. Bivariate Logistic regression analysis was
conducted primarily to check the association of each independent variable with the dependent variable. Multivariate logistic regression models were employed to analyze specific associations between variables. Odds ratio (OR) and 95% confidence interval (CIs) were calculated using logistic regression model to measure the strength of an association. Mean and standard deviation was used to summarize continuous variables. Pvalue <0.05
with corresponding 95% CI were taken significant values
Results: A total of 4,275 TB cases record (2015-2019) were reviewed. The detection rate of TB were 2,151 (50.3%) extra pulmonary TB cases, 929 (21.7%) bacteriologically confirmed pulmonary TB cases, and 1,195 (28.0%) clinically confirmed pulmonary TB cases. Female patients account for 55.5% of the total cases. Patients from ages of 15-34 years were the most affected age groups (51.5 %), and ages of 65 years the least affected age group (7.5%). For HIV status, 2, 804/4275 (65.6 %) were HIV co-infected, of whom
46.5% were male and 53.5% were female. From the total TB patients, 33.0% (929/2804) of PTB+, 42.6% (1195/2804) of PTB- and 76.7% (2151/2804) of the EPTB were co-infected with HIV. Among bacteriologically confirmed pulmonary TB cases, 577 (62.1%) were female within the five-year period from 2015 – 2019. The prevalence of all forms of TB were 922 (21.6%), 812 (19.0%), 843 (19.7%), 876 (20.5%), and 822 (19.2%), respectively. The variables sex, HIV co-infection and age<15 (AOR: 1.7, 1.9, 1.4, CI: 1.4 -2.2, 1.6 -2.3, 1.1-1.7), respectively, were factors associated with TB infection.
Conclusion:. Even though there was a declining trend of tuberculosis burden within the five-year study period, prevention and control strategies needs to be improved to achieve the stop TB strategies set by the WHO. For this successful achievement, a comprehensive TB diagnosis, care, treatment, and prevention approach is needed to improve TB programs continuously and accelerate the fight to End TB in this setting.
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Tuberculosis, trend analysis, Ethiopia