Trends in Tuberculosis Case Notification and Treatment Outcomes after Interventions in 10 Zones of Ethiopia

Abstract

Setting

Amhara and Oromia Regions, Ethiopia.

Objective

To determine trends in case notification rates (CNRs) among new tuberculosis (TB) cases and treatment outcomes of sputum smear-positive (SS+) patients based on geographic setting, sex and age categories.

Methods

We undertook a trend analysis over a 4-year period among new TB cases reported in 10 zones using a trend test, a mean comparison t-test and one-way analysis of variance.

Results

The average CNR per 100 000 population was 128.9: 126.4 in Amhara and 131.4 in Oromia. The CNR in the project-supported zones declined annually by 6.5%, compared with a 14.5% decline in Tigray, the comparator region. TB notification in the intervention zones contributed 26.1% of the national TB case notification, compared to 13.3% before project intervention. The overall male-to-female ratio was 1.2, compared to 0.8 among SS+ children, with a female preponderance. Over 4 years, the cure rate increased from 75% to 88.4%, and treatment success from 89% to 93%. Default, transfer out and mortality rates declined significantly.

Conclusion

Project-supported zones had lower rates of decline in TB case notification than the comparator region; their contribution to national case finding increased, and treatment outcomes improved significantly. High SS+ rates among girls deserve attention.