The first population-based national tuberculosis prevalence survey in Ethiopia, 2010-2011

Kebede, Adisu; Alebachew, Zeleke; Tsegaye, F.; Lemma, Eshetu; Abebe, Almaz; Agonafir, Mulualem; Kebede, Aweke; Demissie, Dereje Bayissa; Girmachew, Feven; Yaregal, Zelalem; Dana, Feleke; Getahun, Mekonen; Fiseha, Y; Meaza, Abyot; Dirse, Nathneal; Timimi, Hazim; Sismanidis, Charalambos; Tadolini, Marina; Onozaki, Ikushi

doi:10.5588/ijtld.13.0417

Cited by 130 publications

(174 citation statements)

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“…For example, in USA compared to the general population, homeless individuals had an approximately tenfold increase in TB prevalence [33]. Extrapolation of this study finding also indicated that about 4.67 times higher burdens of smear positive PTB in homeless individuals than the general population (108/100,000) in Ethiopia [34]. This study point prevalence of smear positive PTB is comparable to a study conducted in Greater London (780/100,000) [32].…”

Section: Discussionmentioning

confidence: 74%

Smear positive pulmonary tuberculosis and associated factors among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia

Semunigus

Tessema

Eshetie

et al. 2016

Ann Clin Microbiol Antimicrob

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BackgroundTuberculosis (TB) remains one of the globe’s deadliest communicable diseases. The homeless individuals are at high risk to acquire TB and multi-drug resistant TB (MDR-TB), because of their poor living conditions and risky behaviors. Tuberculosis and MDR-TB in the homeless individuals can pose a risk to entire communities. However, the magnitude of the problem is not known in Ethiopia. Therefore, the aim of this study was to determine the prevalence and associated factors of smear positive pulmonary TB (PTB) and MDR-TB among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia.MethodsA community based cross-sectional study design was conducted from September 2014 to June 2015. Using an active screening with cough of ≥2 weeks, 351 TB suspects homeless individuals were participated in this study. Data were collected by using pre-tested and structured questionnaire. Spot-morning-spot sputum sample was collected and examined for acid-fast bacilli (AFB) using fluorescence microscopy by Auramine O staining technique. All AFB positive sputum was further analyzed by GeneXpert for detection of Mycobacterium tuberculosis complex and rifampicin resistant gene. Univariate and multivariate logistic regressions were applied to identify factors associated with smear positive PTB and P value <0.05 was considered as statistically significant.ResultsThe prevalence of smear positive PTB was 2.6 % (95 % CI 1.3–5) among TB suspect homeless individuals. Extrapolation of this study finding implies that there were 505 smear positive PTB per 100,000 homeless individuals. All smear positive PTB sputum specimens were further analyzed by GeneXpert assay, the assay confirmed that all were positive for MTBC but none were resistant to RIF or MDR. Smoking cigarette regularly for greater than 5 years (AOR 10.1, 95 % CI 1.1, 97.7), body mass index lower than 18.5 (AOR 6.9, 95 % CI 1.12, 41.1) and HIV infection (AOR 6.8, 95 % CI 1.1, 40.1) were significantly associated with smear positive PTB.ConclusionThe prevalence of smear positive PTB among TB suspect homeless individuals was 2.6 %. Among smear positive PTB, prevalence of HIV co-infection was very high 5 (55.5 %). Smoking cigarette regularly for greater than 5 years, BMI lower than 18.5 and HIV infection were factors associated with smear positive PTB. Special emphasis is needed for homeless individuals to exert intensive effort to identify undetected TB cases to limit the circulation of the disease into the community.

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Section: Discussionmentioning

confidence: 74%

Smear positive pulmonary tuberculosis and associated factors among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia

Semunigus

Tessema

Eshetie

et al. 2016

Ann Clin Microbiol Antimicrob

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“…Experts in mapping and epidemiology were involved in harmonizing the two protocols and resolved differences between the two approaches. The planning drew on experience from previous large scale studies in the country such as the Malaria Indicators Survey [31, 32], previous LF mapping [23] and the national tuberculosis survey [32]. After the final protocol was developed, disease specific training manual and standard operating procedure (Additional file 1) for conducting the mapping were developed.…”

Section: Resultsmentioning

confidence: 99%

Integrated mapping of lymphatic filariasis and podoconiosis: lessons learnt from Ethiopia

et al. 2014

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BackgroundThe World Health Organization (WHO), international donors and partners have emphasized the importance of integrated control of neglected tropical diseases (NTDs). Integrated mapping of NTDs is a first step for integrated planning of programmes, proper resource allocation and monitoring progress of control. Integrated mapping has several advantages over disease specific mapping by reducing costs and enabling co-endemic areas to be more precisely identified. We designed and conducted integrated mapping of lymphatic filariasis (LF) and podoconiosis in Ethiopia; here we present the methods, challenges and lessons learnt.MethodsIntegrated mapping of 1315 communities across Ethiopia was accomplished within three months. Within these communities, 129,959 individuals provided blood samples that were tested for circulating Wuchereria bancrofti antigen using immunochromatographic card tests (ICT). Wb123 antibody tests were used to further establish exposure to LF in areas where at least one ICT positive individual was detected. A clinical algorithm was used to reliably diagnose podoconiosis by excluding other potential causes of lymphoedema of the lower limb.ResultsA total of 8110 individuals with leg swelling were interviewed and underwent physical examination. Smartphones linked to a central database were used to collect data, which facilitated real-time data entry and reduced costs compared to traditional paper-based data collection approach; their inbuilt Geographic Positioning System (GPS) function enabled simultaneous capture of geographical coordinates. The integrated approach led to efficient use of resources and rapid mapping of an enormous geographical area and was well received by survey staff and collaborators. Mobile based technology can be used for such large scale studies in resource constrained settings such as Ethiopia, with minimal challenges.ConclusionsThis was the first integrated mapping of podoconiosis and LF globally. Integrated mapping of podoconiosis and LF is feasible and, if properly planned, can be quickly achieved at nationwide scale.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-3305-7-397) contains supplementary material, which is available to authorized users.

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“…4 A more proactive strategy, such as community-based screening, can identify large numbers of undiagnosed prevalent TB cases, as demonstrated by epidemiologic studies in China and other high-burden countries. 2,5–7 One epidemiologic study conducted at eight sites in China compared passive vs. active case finding (ACF), and found TB prevalence obtained through active screening was significantly higher than TB registry data of other townships in the same region over the same period. 8 Based on a review of available evidence, the World Health Organization (WHO) issued active case screening recommendations in 2013.…”

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confidence: 99%

Community-based active case finding for tuberculosis in rural western China: a cross-sectional study

Chen

Yang

Gào

et al. 2017

int j tuberc lung dis

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SUMMARY SETTING Current passive case finding strategies are not effective at identifying tuberculosis (TB) patients in rural China. OBJECTIVE To evaluate a community-based, active case finding (ACF) scheme in identifying symptomatic individuals with TB. DESIGN We conducted door-to-door household visits of all residents aged ⩾15 years at two rural sites to screen for TB symptoms. Individuals with symptoms were enrolled and asked to provide three sputum samples. All participants underwent chest X-ray, and microbiologic detection of Mycobacterium tuberculosis from sputum samples using microscopy, solid culture and Xpert® MTB/RIF was performed. RESULTS Among the 19 334 residents screened for TB symptoms, 865 (4.5%) reported having ⩾1 symptom. A total of 52 TB cases were detected, 11 of whom had microbiologic confirmation. Xpert identified all five M. tuberculosis culture-positive cases and yielded an additional three diagnoses. Prevalence of newly detected TB at the two sites through ACF was respectively 475 and 196 per 100 000 population. These estimates are respectively four and eight times, on average, higher than those identified through passive surveillance during the previous 5-year period for the two sites. CONCLUSION Community-based symptom screening followed by laboratory tests was found to be feasible and effective in increasing TB case finding in rural China.

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The first population-based national tuberculosis prevalence survey in Ethiopia, 2010-2011

Abstract: We found that the TB burden was lower than previously thought, which may indicate better programme performance. However, a high proportion of TB among young persons suggests that TB is circulating in the community and that there is a need for more efforts to limit the spread of TB disease.

Cited by 130 publications

References 4 publications

Smear positive pulmonary tuberculosis and associated factors among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia

Smear positive pulmonary tuberculosis and associated factors among homeless individuals in Dessie and Debre Birhan towns, Northeast Ethiopia

Integrated mapping of lymphatic filariasis and podoconiosis: lessons learnt from Ethiopia

Community-based active case finding for tuberculosis in rural western China: a cross-sectional study

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