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      Trends of Tuberculosis Disease from 2013–2018 in Bale Zone, Oromia Region, Ethiopia. Retrospective Review

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          Abstract

          Purpose

          Tuberculosis is a common global public health problem. Ethiopia is among the thirty top Tuberculosis burden countries. Trends of tuberculosis disease in general and at the district level in the Bale Zone have not been assessed and no adequate information existed for informed decision-making. This study was to describe the trends and physical distribution of the tuberculosis disease in the Bale Zone from 2013 to 2018.

          Methods

          We reviewed the reported data of tuberculosis from 2013 to 2018 in March 2019 and extracted data of tuberculosis from the Bale Zone health information system database. Analysis of the six-year data of tuberculosis was conducted after the data was cleaned and checked for completeness.

          Results

          We recruited a total of 11, 268 tuberculosis cases. The proportions of sputum smear-positive tuberculosis (SS+), sputum smear-negative tuberculosis (SS−), and extra-pulmonary tuberculosis (EPTB) cases were 40.4%, 29.6% and 30%, respectively. Of all cases, 81.9% are aged greater than 15 years. Prevalence of all types of tuberculosis was 0.005%, 0.127%, 0.133%, 0.136%, 0.131% and 0.093% in 2013, 2014, 2015, 2016, 2017 and 2018, respectively. The death rate from positive pulmonary tuberculosis was 0%. 2.74, 2.10, 2.06, 1.04, and 2.75 in 2013, 2014, 2015, 2016, 2017 and 2018, respectively. The highest average prevalence rate was 198, 152 and 142 per 100,000 populations in Berbere, Rayitu, and Gura-Dhamole Woreda, respectively.

          Conclusion

          The proportion of sputum smear-positive tuberculosis was high in the Bale Zone. Bale Zone should give more attention to the Tuberculosis program to tackle sputum smear positive. We recommended researchers investigate further research to identify determinants in districts with a high prevalence rate of tuberculosis.

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          Most cited references20

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          Diagnosis and Treatment of Extrapulmonary Tuberculosis

          Extrapulmonary tuberculosis (EPTB) constitutes about 20% of all cases of tuberculosis (TB) in Korea. Diagnosing EPTB remains challenging because clinical samples obtained from relatively inaccessible sites may be paucibacillary, thus decreasing the sensitivity of diagnostic tests. Whenever practical, every effort should be made to obtain appropriate specimens for both mycobacteriologic and histopathologic examinations. The measurement of biochemical markers in TB-affected serosal fluids (adenosine deaminase or gamma interferon) and molecular biology techniques such as polymerase chain reaction may be useful adjuncts in the diagnosis of EPTB. Although the disease usually responds to standard anti-TB drug therapy, the ideal regimen and duration of treatment have not yet been established. A paradoxical response frequently occurs during anti-TB therapy. It should be distinguished from other causes of clinical deterioration. Surgery is required mainly to obtain valid diagnostic specimens and to manage complications. Because smear microscopy or culture is not available to monitor patients with EPTB, clinical monitoring is the usual way to assess the response to treatment.
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            Biological differences between the sexes and susceptibility to tuberculosis.

            Globally, far more men than women have tuberculosis. Although the cause of this bias is uncertain, epidemiological factors have historically been considered the driving force. Here, we discuss evidence that biological differences between the sexes may also be important and can affect susceptibility to mycobacterial infection. We discuss the possible underlying mechanisms, with particular focus on how sex hormones modulate the immune responses necessary for resistance to tuberculosis. Studying these differences may provide valuable insight into the components that constitute an effective immune response to this deadly pathogen. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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              Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study

              Tuberculosis (TB) is one of the major public health and socio-economic issues in the 21st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS) are among the major indicators of the performance of a national TB control program. Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013) TB record of TB clinic of the hospital was reviewed. A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3%) were male, 1015 (66%) were from rural areas, 544 (35.4%) were smear positive pulmonary TB (PTB+), 816 (53.1%) were smear negative pulmonary TB (PTB-) and 177(11.5%) were extra pulmonary TB (EPTB) patients. Records of the 1537 TB patients showed that 181 (11.8%) were cured, 1129(73.5%) completed treatment, 171 (11.1%) defaulted, 52 (3.4%) died and 4 (0.3%) had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012–May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21–2.20) compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26–2.50) and EPTB (AOR = 2.07, 95% CI: 1.28–3.37) compared to the PTB+ patients. In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to patients from rural area is recommended.
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                Author and article information

                Journal
                Infect Drug Resist
                Infect Drug Resist
                idr
                Infection and Drug Resistance
                Dove
                1178-6973
                21 November 2022
                2022
                : 15
                : 6723-6730
                Affiliations
                [1 ]Field Epidemiology Training Program, Jimma University Jimma , Jimma, Oromia Regional State, Ethiopia
                [2 ]Health Emergency, World Health Organization , Nekemte, Oromia Regional State, Ethiopia
                [3 ]Department of Internal Medicine, Arsi University , Asella, Oromia Regional State, Ethiopia
                [4 ]Department of Public Health, Arsi University , Asella, Oromia Regional State, Ethiopia
                Author notes
                Correspondence: Mohammed Hasen Badeso, Po.Box 61, Gindhir, Tel +251923728803, Email direhasen@gmail.com
                Author information
                http://orcid.org/0000-0002-4668-9638
                http://orcid.org/0000-0003-1228-5675
                http://orcid.org/0000-0003-0271-5264
                http://orcid.org/0000-0002-8734-9170
                http://orcid.org/0000-0001-7691-8385
                Article
                384402
                10.2147/IDR.S384402
                9697398
                36438646
                95e54e94-fc7e-4c4e-bd93-7bc8f8479836
                © 2022 Hasen Badeso et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 16 September 2022
                : 17 November 2022
                Page count
                Figures: 4, Tables: 1, References: 20, Pages: 8
                Categories
                Original Research

                Infectious disease & Microbiology
                tuberculosis,trend,bale
                Infectious disease & Microbiology
                tuberculosis, trend, bale

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