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Arega, Balew, Amdemeskel Mersha, Abraham Minda, Yitagesu Getachew, Alazar Sitotaw, Tefera Gebeyehu, and Asnake Agunie. "Epidemiology and the diagnostic challenge of extra-pulmonary tuberculosis in a teaching hospital in Ethiopia." PLOS ONE 15, no. 12 (December 15, 2020): e0243945. http://dx.doi.org/10.1371/journal.pone.0243945.
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Background Ethiopia reported a high rate of extra-pulmonary tuberculosis (EPTB) and the cases are increasing since the last three decades. However, diagnostic evidence to initiate TB treatment among EPTB cases is not well known. Therefore, we described the epidemiology and assessed how EPTB is diagnosed in a teaching hospital in Ethiopia. Methods We conducted a retrospective review among all adult EPTB cases diagnosed in Yekatit 12 Hospital Medical College from 2015 to 2019. Using a standardized data abstraction sheet, we collected data from patients’ medical records on sociodemographic, sites, and laboratory diagnosis of EPTB cases. Results Of the 965 total TB cases, 49.8%(481) had a recorded diagnosis of EPTB during the study period. The mean age of EPTB patients was 32.9 years (SD±13.9) and 50.7% were males. Tubercular lymphadenitis (40.3%), abdominal (23.4%), and pleural TB(13.5%) were the most common sites of EPTB involvement, followed in descending order by the genitourinary, skeletal, central nervous system, abscess, breast, and laryngeal TB. We found a histopathology finding consistent with EPTB in 59.1% of cases, Acid-fast bacilli positive in 1.5%, and the rest diagnosed on radiological grounds. In the majority of cases, more than one diagnostic method was used to diagnose EPTB cases. Conclusions Nearly half of TB patients had a recorded diagnosis of EPTB that comprise heterogeneous anatomical sites. All EPTB patients were started anti-TB therapy without definitive microbiology results. This indicates the diagnostic challenge of EPTB faced in our setting and proves to be significant for TB control in Ethiopia.
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Tufa and Denning. "The Burden of Fungal Infections in Ethiopia." Journal of Fungi 5, no. 4 (November 22, 2019): 109. http://dx.doi.org/10.3390/jof5040109.
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The burden of severe fungal infections (FIs) is not well addressed in Ethiopia. We have estimated the burden of FIs from multiple demographic sources and by searching articles from PubMed. Opportunistic FIs were estimated using modelling and 2017 national HIV data. The burdens of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA) were estimated by using the prevalence of asthma, chronic obstructive pulmonary disease, and annual the incidence of tuberculosis. Of the 105,000,000 estimated Ethiopian population, 610,000 are thought to have HIV infection. Our estimation of HIV-related FIs were: 9900 cryptococcal meningitis (CM), 12,700 Pneumocystis jirovecii pneumonia (PCP), 76,300 oral and 56,000 oesophageal candidiasis cases. A remarkable 7,051,700 4–14-year-olds probably have tinea capitis and 1,469,000 women probably have recurrent Candida vaginitis. There were 15,200 estimated CPA cases (prevalence) and 11,500 invasive aspergillosis (IA) cases (incidence). Data are scant, but we estimated 5300 candidaemia and 800 Candida peritonitis cases. In conclusion, approximately 8% of Ethiopians suffer from FIs annually, mostly schoolchildren with tinea capitis. IA, CM and PCP are the major causes of fungal deaths. The absence of CD4 count is challenging the identification of HIV patients at risk of opportunistic FIs. There is a pressing need to improve FI diagnosis, probably including national surveillance.
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Mohammed, Hussen, Lemessa Oljira, Kedir Teji Roba, Esther Ngadaya, Tigest Ajeme, Tewodros Haile, Achenef Kidane, Tsegahun Manyazewal, Abebaw Fekadu, and Getnet Yimer. "Burden of tuberculosis and challenges related to screening and diagnosis in Ethiopia." Journal of Clinical Tuberculosis and Other Mycobacterial Diseases 19 (May 2020): 100158. http://dx.doi.org/10.1016/j.jctube.2020.100158.
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Habtamu Molla. "Yielding Accuracy of Morning and Spot Sputum Samples for Diagnosis Mycobacterium Tuberculosis Using Gene Xpert MTB/RIF Assay at EPHI, Addis Ababa, Ethiopia." Journal of Multidisciplinary Research in Healthcare 6, no. 1 (July 17, 2020): 1–5. http://dx.doi.org/10.15415/jmrh.2019.61001.
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Background: Tuberculosis is a global health problem and leading cause of mortality and morbidity in the world. Correct diagnosis of tuberculosis is the main challenge for control of tuberculosis. World health organization has prioritized improving diagnostic guidelines and tests for TB diagnosis. Priority has been given for development of new Tuberculosis diagnostic methods. But diagnosis of Tuberculosis highly affected by quality specimen collected which has been given less attention. The aim of this is to assess Yielding accuracy of morning and spot sputum samples for diagnosis Mycobacterium tuberculosis using Gene Xpert Mycobacterium Tuberculosis (MTB)/Rifampicin Resistance (RIF).Methodology: Cross sectional study was conducted and convenient sampling technique used to select participants. Checklists used to collect the data from April 1 to May 30, 2018 G.C. A total of two hundred twenty two (222) sputum samples from 111 suspected tuberculosis patients were analyzed using Gene Xpert MTB/RIF Assay. SPSS version 20 was used for statistical analysis. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research show an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant associationwith TB positivity.Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not association with TB positivity using Gene Xpert MTB/RIF Assay. Results: From 111 TB suspected patients, 55.9% were male and the rest of 44.1% was female. In terms of sample quality, 81.1% morning sputum samples and 79.3% spot sputum samples were had good sample quality. The outcomes of the research shows an increase in odds value in sputum quality and sputum consistency for TB diagnosis. But, the relation is not significant association with TB positivity.
Conclusion: Based on the results of this study, the diagnosis of TB using spot sputum samples as well as using morning sputum samples is almost similar for the detection of MTB by Gene Xpert MTB/RIF Assay. Physical Quality of sputum sample or consistency is not associated with TB positivity using Gene Xpert MTB/RIF Assay.
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Melaku, Samuel, Hardeep Rai Sharma, and Getahun Asres Alemie. "Pastoralist Community’s Perception of Tuberculosis: A Quantitative Study from Shinille Area of Ethiopia." Tuberculosis Research and Treatment 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/475605.
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Background. In Ethiopia the prevalence of all forms of TB is estimated at 261/100 000 population, leading to an annual mortality rate of 64/100 000 population. The incidence rate of smear-positive TB is 108/100 000 population.Objectives. To assess knowledge, attitudes, and practices regarding TB among pastoralists in Shinille district, Somali region, Ethiopia.Method. A community-based cross-sectional study was conducted among 821 pastoralists aged >18 years and above from February to May, 2011 using self-structured questionnaire.Results. Most (92.8%) of the study participants heard about TB, but only 10.1% knew about its causative agent. Weight loss as main symptom, transmittance through respiratory air droplets, and sputum examination for diagnosis were the answers of 34.3%, 29.9%, and 37.9% of pastoralists, respectively. The majority (98.3%) of respondents reported that TB could be cured, of which 93.3% believed with modern drugs. About 41.3% of participants mentioned covering the nose and mouth during sneezing and coughing as a preventive measure. The multivariate logistic regression analysis indicated that household income >300 Ethiopian Birr and Somali ethnicity were associated with high TB knowledge. Regarding health seeking behaviour practice only 48.0% of the respondents preferred to visit government hospital and discuss their problems with doctors/health care providers.Conclusion. This study observed familiarity with gaps and low overall knowledge on TB and revealed negative attitudes like discrimination intentions in the studied pastoral community.
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Addisu, Melese Dagnaw, and Zeleke Tiruneh Balew. "Laboratory diagnostic systems used in the diagnosis of tuberculosis in Ethiopia: A systematic review." Journal of Medical Laboratory and Diagnosis 5, no. 2 (February 28, 2014): 14–21. http://dx.doi.org/10.5897/jmld2013.0086.
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Getnet, Fentabil, Meaza Demissie, Alemayehu Worku, Tesfaye Gobena, Rea Tschopp, and Berhanu Seyoum. "Longer Delays in Diagnosis and Treatment of Pulmonary Tuberculosis in Pastoralist Setting, Eastern Ethiopia." Risk Management and Healthcare Policy Volume 13 (June 2020): 583–94. http://dx.doi.org/10.2147/rmhp.s258186.
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Shiferaw, Melashu Balew, Hiwot Amare Hailu, Abebe Alemu Fola, Mulatu Melese Derebe, Aimro Tadese Kebede, Abayneh Admas Kebede, Manamnot Agegne Emiru, and Zelalem Dessie Gelaw. "Tuberculosis Laboratory Diagnosis Quality Assurance among Public Health Facilities in West Amhara Region, Ethiopia." PLOS ONE 10, no. 9 (September 16, 2015): e0138488. http://dx.doi.org/10.1371/journal.pone.0138488.
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Diriba, Getu, Abebaw Kebede, Habteyes Hailu Tola, Bazezew Yenew, Shewki Moga, Desalegn Addise, Ayinalem Alemu, et al. "Molecular characterization and drug resistance patterns of Mycobacterium tuberculosis complex in extrapulmonary tuberculosis patients in Addis Ababa, Ethiopia." PLOS ONE 15, no. 12 (December 7, 2020): e0243493. http://dx.doi.org/10.1371/journal.pone.0243493.
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Background Molecular characterization of Mycobacterium tuberculosis (MTB) is important to understand the pathogenesis, diagnosis, treatment, and prevention of tuberculosis (TB). However, there is limited information on molecular characteristics and drug-resistant patterns of MTB in patients with extra-pulmonary tuberculosis (EPTB) in Ethiopia. Thus, this study aimed to determine the molecular characteristics and drug resistance patterns of MTB in patients with EPTB in Addis Ababa, Ethiopia. Methods This study was conducted on frozen stored isolates of EPTB survey conducted in Addis Ababa, Ethiopia. A drug susceptibility test was performed using BACTEC-MGIT 960. Species and strain identification were performed using the Geno-Type MTBC and spoligotyping technique, respectively. Data were entered into the MIRU-VNTRplus database to assess the spoligotype patterns of MTB. Analysis was performed using SPSS version 23, and participants’ characteristics were presented by numbers and proportions. Results Of 151 MTB isolates, 29 (19.2%) were resistant to at least one drug. The highest proportion of isolates was resistant to Isoniazid (14.6%) and Pyrazinamide (14.6%). Nine percent of isolates had multidrug-resistant TB (MDR-TB), and 21.4% of them had pre-extensively drug-resistant TB (pre-XDR-TB). Among the 151 MTB isolates characterized by spoligotyping, 142 (94.6%) had known patterns, while 9 (6.0%) isolates were not matched with the MIRU-VNTRplus spoligotype database. Of the isolates which had known patterns, 2% was M.bovis while 98% M. tuberculosis. Forty-one different spoligotype patterns were identified. The most frequently identified SpolDB4 (SIT) wereSIT149 (21.2%), SIT53 (14.6%) and SIT26 (9.6%). The predominant genotypes identified were T (53.6%), Central Asia Strain (19.2%) and Haarlem (9.9%). Conclusion The present study showed a high proportion of MDR-TB and pre-XDR-TB among EPTB patients. The strains were mostly grouped into SIT149, SIT53, and SIT26. The T family lineage was the most prevalent genotype. MDR-TB and pre-XDR-TB prevention is required to combat these strains in EPTB. A large scale study is required to describe the molecular characteristics and drug resistance patterns of MTB isolates in EPTB patients.
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Shimeles, Ezra, Melaku Tilahun, Tsegaye Hailu, Fikre Enquselassie, Abraham Aseffa, Alemayehu Mekonnen, and Getachew Wondimagegn. "Time Interval for Diagnosis of Tuberculosis and Related Expenditure in Selected Health Centers in Addis Ababa, Ethiopia." Advances in Public Health 2019 (December 3, 2019): 1–11. http://dx.doi.org/10.1155/2019/4705139.
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Background. Tuberculosis (TB) has continued to be a major health problem globally, in spite of the efforts to improve the diagnosis, treatment, and prevention. It affects millions of people each year and stands as the second cause of death due to infectious disease in the world. Early case finding and timely initiation of treatment is essential to ensure effective control of the disease as late diagnosis and treatment can aggravate the disease and result in poor outcomes and increase chances of transmission. Although TB services are supposed to be provided free of charge, TB affected families incur different types of costs in the process of seeking care, which might include health and nonhealth related costs. TB programs need to identify the underlying factors for delay and related expenditure for TB related services, in order to devise an effective strategy to reduce them. Therefore, the study aimed to assess the time interval between developing TB symptom until patients start anti-TB treatment and associated cost incurred by patients and families. Methods. This cross-sectional study was conducted among pulmonary TB patients who are bacteriologically confirmed, whose age is above 15 years and diagnosed at health centres in Addis Ababa. Results. The median time interval between onset of symptom and commencement of treatment was 4 weeks (IQR: 3, 6). Most patients with TB symptoms visited several health facilities before the final diagnosis was confirmed, the median number of visits being two, and only 48.8% were diagnosed on their first visit. Hence, they spent a lot of their limited resource in search of getting the right diagnosis. The total combined expenditure for all the visits was estimated to be median (IQR) 172.65 birrs (12, 671). Two variables were found to show statistically significant association with higher expenditure. Respondents who have good level of knowledge about TB are less likely to spend more than the median expenditure almost by a fifth compared to those with limited knowledge on TB, (adjusted odds ratio (AOR) = 0.2, with 95% confidence interval (CI): 0.06, 0.84). Patients who visited public hospitals were almost three times and those who visited private health facilities almost four times more likely to pay more than the median total expenditure, compared to those who visited health centre, AOR (95% CI) = 2.8 (1.53, 5.19) and AOR (CI) of 3.86 (1.06, 14.03), respectively. Conclusion. Patients with TB symptoms visit several health facilities till they are diagnosed, the median duration from onset of symptom till commencement of TB treatment being 4 weeks. It was noted that they face major expenses in the process of navigation to the right care. Two variables had statistically significant association with high pre-diagnosis expenditure, where patients with good level of knowledge about TB are less likely to spend more than the median, while patients who visited public hospitals or private health facilities had very high expenses. Improved public awareness about TB, minimizing service charges and other related fees, and further improvement in increasing access to services could reduce the length of time and expense for TB patients and their families. It is recommended to build capacity of health service providers to update them on programmatic approaches and latest diagnostic algorithm. It is important to strengthen public private partnership for TB services.
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Desalegn, Daniel Melese, Kumera Terfa Kitila, Boja Dufera Taddese, Tinsae Kidanemariam Hailu, Tariku Takle Dinku, Kassahun Demisse Asferie, Hanna Mekonnen Balcha, Chalachew Sisay Gebeyehu, and Girmay Medhin. "Sputum Smear Positive Pulmonary Tuberculosis Diagnostic Dropout Rate in Public Health Facilities, Addis Ababa, Ethiopia." Pulmonary Medicine 2019 (March 20, 2019): 1–6. http://dx.doi.org/10.1155/2019/2905615.
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Background. Prolonged laboratory diagnostic process of tuberculosis can lead to failure to complete the diagnosis and increase dropout rate of smear positive pulmonary tuberculosis (PTB) cases. This implies such dropout patients without completing diagnosis are critical as infected individuals remain untreated in the community, providing more opportunities for transmission of the disease and adversely affecting the epidemic. The aim of this research is to determine the level of smear positive PTB diagnosis dropout rate of spot-morning-spot sputum microscopy diagnosis method in public health facilities, in Addis Ababa, Ethiopia. Methods. Retrospective review of patient documents in 13 public health facilities’ TB laboratory in Addis Ababa was conducted from October 2011 to March 2016. Data was computerized using Epi-info software and analysed using SPSS version 20.0 software. Descriptive numerical summaries were used to present the findings. Association between the dropout rate and demographic variables was assessed by Chi-square (X2). Bivariate model using Odds Ratio (OR) with a 95% Confidence Interval (CI) was calculated. P-Value less than 0.05 was taken as statistically significant. Results. Of 41,884 presumptive TB patients registered during the 53 months for laboratory investigation, 5.9% were positive for the first spot sputum smear microscopy. Among these positive cases, 142 (5.8%) and 298 (12.1%) did not come back to the laboratory to submitted early morning and second spot sputum specimens, respectively. The diagnostic dropout for morning sputum specimen in hospitals was 5.6% (58/1039) and in health centres was 5.9% (84/1424). However, higher proportion of dropout for second spot sputum specimen in hospitals was 16.4% (170/1039), compared to the health centres, 8.9% (128/1424). Diagnostic dropout of sputum smear microscopy had no significant association with sociodemographic variable (P value >0.05), while it had significant association with facility type (P value <0.05). Conclusion. In this study smear positive pulmonary tuberculosis diagnostic dropout rate was high compared to WHO reported for the new strategy shift implying the importance of shifting to same-day approach. Hence, shifting from conventional to same day is crucial to minimize the TB diagnostic dropout rate in the study area and other similar settings. Further research is needed/recommended in the local setting to compare the yield and dropout rates between same-day and conventional sputum smear microscopy approach.
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Asres, Mihret, Amlsha Kahsay, Molla Gedefaw, and Yemane Weldu. "Patients' Delay in Seeking Health Care for Tuberculosis Diagnosis in East Gojjam Zone, Northwest Ethiopia." American Journal of Tropical Medicine and Hygiene 96, no. 5 (May 3, 2017): 1071–75. http://dx.doi.org/10.4269/ajtmh.16-0892.
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Mala, George, Mark G. Spigt, Luc G. Gidding, Roman Blanco, and Geert-Jan Dinant. "Quality of diagnosis and monitoring of tuberculosis in Northern Ethiopia: medical records-based retrospective study." Tropical Doctor 45, no. 4 (April 15, 2015): 214–20. http://dx.doi.org/10.1177/0049475515581126.
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Khogali, M., K. Tayler-Smith, R. Zachariah, M. Gbane, S. Zimble, T. Weyeyso, and A. D. Harries. "Diagnosis of pulmonary tuberculosis in a pastoralist population in Ethiopia: are three sputum specimens needed?" Tropical Medicine & International Health 18, no. 5 (February 26, 2013): 632–35. http://dx.doi.org/10.1111/tmi.12082.
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Korma, Workneh, Adane Mihret, Azeb Tarekegn, Yunhee Chang, Dasom Hwang, Tesfaye Sisay Tessema, and Hyeyoung Lee. "Identification of Circulating miR-22-3p and miR-93-5p as Stable Endogenous Control in Tuberculosis Study." Diagnostics 10, no. 11 (October 23, 2020): 868. http://dx.doi.org/10.3390/diagnostics10110868.
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The diagnosis and prognosis of tuberculosis remains challenging and necessitates the development of a new test that can accurately diagnose and monitor treatment responses. In this regard, miRNA is becoming a potential diagnostic and prognostic biomarker which differentiates treatment respondents from non-respondents for various non-infectious and infectious diseases, including tuberculosis. The concentration of miRNAs varies based on cell type, disease, and site of infection, implicating that selection of an optimal reference gene is crucial, and determines the quantification of transcript level and biological interpretation of the data. Thus, the study evaluated the stability and expression level of five candidate miRNAs (let-7i-5p, let-7a-5p, miRNA-16-5p, miRNA-22-3p and miRNA-93-5p), including U6 Small Nuclear RNA (RNU6B) to normalize circulating miRNAs in the plasma of 68 participants (26 healthy controls, 23 latent, and 19 pulmonary tuberculosis infected) recruited from four health centers and three hospitals in Addis Ababa, Ethiopia. The expression levels of miRNAs isolated from plasma of culture confirmed newly diagnosed pulmonary tuberculosis patients were compared with latently infected and non-infected healthy controls. The qPCR data were analyzed using four independent statistical tools: Best Keeper, Genorm, Normfinder and comparative delta-Ct methods, and the data showed that miRNA-22-3p and miRNA-93-5p were suitable plasma reference miRNAs in a tuberculosis study.
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Abdu, Muhammed, Awraris Balchut, Eshetu Girma, and Wondwosen Mebratu. "Patient Delay in Initiating Tuberculosis Treatment and Associated Factors in Oromia Special Zone, Amhara Region." Pulmonary Medicine 2020 (June 12, 2020): 1–10. http://dx.doi.org/10.1155/2020/6726798.
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Background. Tuberculosis (TB) is a major global public health problem. The disease is a leading cause of morbidity and mortality in Ethiopia. Early identification of cases and commencement of effective chemotherapy is an effective method to control the spread of tuberculosis. Delay in diagnosis and starting tuberculosis treatment increases severity, risk of mortality, and transmission of the disease in the community. Objective. The purpose of this study is to assess the magnitude of patient delay in initiating tuberculosis treatment and its associated factors among tuberculosis patients in health facilities of Oromia Special Zone, Ethiopia. Methods. A facility-based cross-sectional study was conducted in Oromia Special Zone. Data were collected using pretested questionnaires from patients with tuberculosis who are on treatment during the study period. The simple random sampling method was used to select health facilities and study participants. Data were entered using Epi Info version 7.2 and analyzed by SPSS version 23. Bivariate and multivariate logistic regression analyses were used to see the significance of association between the outcome and independent variables. A P value < 0.05 was considered statistically significant. Results. Three hundred and eighty-seven tuberculosis patients aged 18 years and above enrolled in the study. Among these, 223 (57.6%) were males, 194 (50.1%) were married, and 206 (53.2%) lived in rural areas. The mean age of respondents was 35 years. The median patient delay was 35 (IQR=30) days, and 54.4% of patients seek their first consultation after 21 days. Patients who have a basic schooling level (AOR=0.45, 95% CI: 0.23, 0.89) compared with the college/university level, long distance greater than 10 km (AOR=3.23, 95% CI: 1.97, 5.42), seeking treatment from informal source and private drug stores (AOR=3.01, 95% CI: 1.52, 5.95), extrapulmonary tuberculosis (AOR=2.30, 95% CI: 1.26, 4.23), and poor knowledge about tuberculosis (AOR=1.58, 95% CI: 1.01, 2.49) were associated factors that predict patient delay. Conclusion and Recommendation. A significant proportion of tuberculosis patients delayed to seek treatment. Health promotion and education involving different stake holders will make the community create awareness about tuberculosis that could help reduce delays in initiating tuberculosis treatment.
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Awoke, Netsanet, Bedado Dulo, and Feven Wudneh. "Total Delay in Treatment of Tuberculosis and Associated Factors among New Pulmonary TB Patients in Selected Health Facilities of Gedeo Zone, Southern Ethiopia, 2017/18." Interdisciplinary Perspectives on Infectious Diseases 2019 (June 2, 2019): 1–14. http://dx.doi.org/10.1155/2019/2154240.
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Background. TB is an infectious disease caused by the bacillus Mycobacterium TB complex. It is a major public health concern causing devastating illness in millions of people each year and one of the top 10 causes of death worldwide following HIV pandemic. It demands huge costs each year for prevention, diagnosis, and treatment of TB. Global TB control progress depends on major advances in early diagnosis and treatment. Despite progress in providing diagnosis and preventive treatment of TB, big detection and treatment gaps remained with delayed diagnosis and treatment of TB especially in resource-limited countries. This is mainly because of factors related to the patient and health care system including sociodemographic, economic, and cultural barriers to accessing TB care. Objective. The study conducted in Gedeo Zone, Southern Ethiopia, had the primary purpose of identifying the median delay in starting a correct TB treatment and the associated factors for such a delay in patients newly diagnosed with PTB in selected health facilities of Gedeo Zone, Southern Ethiopia, 2017/18. Methods. Institutional based cross-sectional study was conducted among new pulmonary TB patients in selected health institution of Gedeo Zone, Southern Ethiopia, 2017, from October, 2017, to May, 2018. All new pulmonary TB patients who fulfill the inclusion criteria during the study period were included in the study after informed consent was obtained from the participants. Data was cleaned, coded, and entered into SPSS version 20 for analysis. A frequency for variables was calculated. Chi-square was used to screen the possible potential associated factors and multivariate analysis was used to ascertain the association between variables. All statistical tests values of p<0.05 were considered as statistically significant. Result. The median total in treatment of TB was 60 days. Among the total study participants, 50.9% of the participants have unacceptable/longer total delay in TB treatment. Being of female gender, not attending formal education, having rural residency, having poor knowledge of TB, having home distance >10Km from the nearest health facility, visiting nonformal health care provider, and taking antibiotic treatment before TB diagnosis empirically were identified as significant independently associated factors for unacceptable total treatment in TB. Conclusions. There was higher median total delay in treatment of TB (60 days) and an overall prevalence of 50.9% unacceptable/longer total delay in treatment of TB. Female gender, rural residence, not attending formal education, visiting nonformal health facility as first health care seeking, having poor knowledge of TB, and having antibiotic treatment before TB diagnosis were identified as independent significant associated factors.
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Maru, Minwuyelet, Solomon H. Mariam, Tekle Airgecho, Endalamaw Gadissa, and Abraham Aseffa. "Prevalence of Tuberculosis, Drug Susceptibility Testing, and Genotyping of Mycobacterial Isolates from Pulmonary Tuberculosis Patients in Dessie, Ethiopia." Tuberculosis Research and Treatment 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/215015.
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Due to their initially seemingly high cost, timely diagnosis and effective treatment of tuberculosis (TB) are usually hampered by lack or shortage of resources in many high TB burden countries. However, the benefits of effective treatment can eventually outweigh those of empirical treatment. Here, a cross-sectional study was conducted on samples from smear-positive new and retreatment TB patients. Data on sociodemographic and HIV status were collected. Samples were cultured for identification, conventional drug sensitivity testing, and molecular typing by deletion typing and spoligotyping. The results showed the youth were disproportionately affected. New cases were being treated following general treatment guidelines only. Monoresistance or multiple drug resistance was found in 16.5% of new patients. Spoligotyping showed that there were 44 patterns with families H3 and T1 (lineage 4) and CAS-Delhi (lineage 3) being dominant. Some rare patterns from lineage 7 were also found. Spoligotype pattern, HIV positivity, and previous treatment were not associated with drug resistance. That the vast majority of the patients were new cases and young and the large number of these patients with mono- or multiple drug resistance indicate that most TB cases are due to recent transmissions and that urgent actions are needed to curb the transmissions.
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Woldeyohannes, Demelash, Yohannes Tekalegn, Biniyam Sahiledengle, Tesfaye Assefa, Rameto Aman, Zeleke Hailemariam, Lillian Mwanri, and Alemu Girma. "Predictors of mortality and loss to follow-up among drug resistant tuberculosis patients in Oromia Hospitals, Ethiopia: A retrospective follow-up study." PLOS ONE 16, no. 5 (May 6, 2021): e0250804. http://dx.doi.org/10.1371/journal.pone.0250804.
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Background Drug resistance tuberculosis (DR-TB) patients’ mortality and loss to follow-up (LTF) from treatment and care is a growing worry in Ethiopia. However, little is known about predictors of mortality and LTF among drug-resistant tuberculosis patients in Oromia region, Ethiopia. The current study aimed to identify predictors of mortality and loss to follow-up among drug resistance tuberculosis patients in Oromia Hospitals, Ethiopia. Methods A retrospective follow up study was carried out from 01 November 2012 to 31 December 2017 among DR-TB patients after calculating sample size using single proportion population formula. Mean, median, Frequency tables and bar charts were used to describe patients’ characteristics in the cohort. The Kaplan-Meier curve was used to estimate the probability of death and LTF after the treatment was initiated. The log-rank test was used to compare time to death and time to LTF. The Cox proportional hazard model was used to determine predictors of mortality and LTF after DR-TB diagnosis. The Crude and adjusted Cox proportional hazard ratio was used to measure the strength of association whereas p-value less than 0.05 were used to declare statistically significant predictors. Result A total of 406 DR-TB patients were followed for 7084 person-months observations. Among the patients, 71 (17.5%) died and 32 (7.9%) were lost to follow up (LTF). The incidence density of death and LTF in the cohort was 9.8 and 4.5 per 1000 person-months, respectively. The median age of the study participants was 28 years (IQR: 27.1, 29.1). The overall cumulative survival probability of patients at the end of 24 months was 77.5% and 84.5% for the mortality and LTF, respectively. The independent predictors of death was chest radiographic findings (AHR = 0.37, 95% CI: 0.17–0.79) and HIV serostatus 2.98 (95% CI: 1.72–5.19). Drug adverse effect (AHR = 6.1; 95% CI: 2.5, 14.34) and culture test result (AHR = 0.1; 95% CI: 0.1, 0.3) were independent predictors of LTF. Conclusion This study concluded that drug-resistant tuberculosis mortality and LTF remains high in the study area. Continual support of the integration of TB/HIV service with emphasis and work to identified predictors may help in reducing drug-resistant tuberculosis mortality and LTF.
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Yimer, Solomon A., Gunnstein Norheim, Amine Namouchi, Ephrem D. Zegeye, Wibeke Kinander, Tone Tønjum, Shiferaw Bekele, et al. "Mycobacterium tuberculosis Lineage 7 Strains Are Associated with Prolonged Patient Delay in Seeking Treatment for Pulmonary Tuberculosis in Amhara Region, Ethiopia." Journal of Clinical Microbiology 53, no. 4 (February 11, 2015): 1301–9. http://dx.doi.org/10.1128/jcm.03566-14.
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Recent genotyping studies ofMycobacterium tuberculosisin Ethiopia have reported the identification of a new phylogenetically distinctM. tuberculosislineage, lineage 7. We therefore investigated the genetic diversity and association of specificM. tuberculosislineages with sociodemographic and clinical parameters among pulmonary TB patients in the Amhara Region, Ethiopia. DNA was isolated fromM. tuberculosis-positive sputum specimens (n= 240) and analyzed by PCR and 24-locus mycobacterial interspersed repetitive unit–variable-number tandem-repeat (MIRU-VNTR) analysis and spoligotyping. Bioinformatic analysis assigned theM. tuberculosisgenotypes to global lineages, and associations between patient characteristics and genotype were evaluated using logistic regression analysis. The study revealed a high diversity of modern and premodernM. tuberculosislineages, among which approximately 25% were not previously reported. Among theM. tuberculosisstrains (n= 138) assigned to seven subgroups, the largest cluster belonged to the lineage Central Asian (CAS) (n= 60; 26.0%), the second largest to lineage 7 (n= 36; 15.6%), and the third largest to the lineage Haarlem (n= 35; 15.2%). Four sublineages were new in the MIRU-VNTRplus database, designated NW-ETH3, NW-ETH1, NW-ETH2, and NW-ETH4, which included 24 (10.4%), 18 (7.8%), 8 (3.5%), and 5 (2.2%) isolates, respectively. Notably, patient delay in seeking treatment was significantly longer among patients infected with lineage 7 strains (Mann-Whitney test,P< 0.008) than in patients infected with CAS strains (adjusted odds ratio [AOR], 4.7; 95% confidence interval [CI], 1.6 to 13.5). Lineage 7 strains also grew more slowly than otherM. tuberculosisstrains. Cases of Haarlem (OR, 2.8; 95% CI, 1.2 to 6.6) and NW-ETH3 (OR, 2.8; 95% CI, 1.0 to 7.3) infection appeared in defined clusters. Intensified active case finding and contact tracing activities in the study region are needed to expedite diagnosis and treatment of TB.
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Mohammedhussein, Mustefa, Mohammedamin Hajure, Jemal Ebrahim Shifa, and Tahir Ahmed Hassen. "Perceived stigma among patient with pulmonary tuberculosis at public health facilities in southwest Ethiopia: A cross-sectional study." PLOS ONE 15, no. 12 (December 8, 2020): e0243433. http://dx.doi.org/10.1371/journal.pone.0243433.
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Objectives Although tuberculosis (TB) related stigma has a significant impact on the diagnosis, patient adherence with treatment, and recovery from the disease, there is limited evidence from Ethiopia regarding perceived stigma among patient with pulmonary tuberculosis (PTB).The purpose of this study was to assess perceived stigma and associated factors among patient with PTB on treatment in southwest Ethiopia. Methods Institution-based cross-sectional study was conducted from April to May 2019 among 410 patient with PTB. Data were collected by using the perceived tuberculosis stigma scale. Epi data v3.1 and SPSSv23 were used for data entry and analysis. Multivariable logistic regression models were fitted to identify factors associated with perceived stigma. Results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Result Prevalence of perceived stigma among patient with Pulmonary tuberculosis was 57.1% (95% CI: 52.2, 61.7). Poor social support (AOR = 2.41; 95% CI: 1.06, 5.48), above a month duration of illness (AOR = 2.48; 95% CI: 1.33, 4.64), high perceived stress (AOR = 1.95; 95% CI:1.09, 3.49), current khat use (AOR = 1.88; 95% CI:1.05, 3.37), and presence of depression (AOR = 8.18; 95% CI:4.40, 15.22) were significantly associated with perceived stigma. Patient with HIV co-infection were 5.67 times (AOR = 5.67; 95% CI: 2.32, 13.87) more likely to have Perceived stigma than their counterparts. Conclusion TB related stigma was reported by more than half of the study participant. Stigma reduction measures are needed to lower TB related stigma perceived by the patient, the level of distress associated with it, and to promote the psychological wellbeing of patient with TB.
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Getnet, Fentabil, Meaza Demissie, Alemayehu Worku, Tesfaye Gobena, Berhanu Seyoum, Rea Tschop, and Chris Anderson. "Determinants of Patient Delay in Diagnosis of Pulmonary Tuberculosis in Somali Pastoralist Setting of Ethiopia: A Matched Case-Control Study." International Journal of Environmental Research and Public Health 16, no. 18 (September 12, 2019): 3391. http://dx.doi.org/10.3390/ijerph16183391.
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Background: Healthcare-seeking behavior is the basis to ensure early diagnosis and treatment of tuberculosis (TB) in settings where most cases are diagnosed upon self-presentation to health facilities. Yet, many patients seek delayed healthcare. Thus, we aimed to identify the determinants of patient delay in diagnosis of pulmonary TB in Somali pastoralist area, Ethiopia. Methods: A matched case-control study was conducted between December 2017 and October 2018. Cases were self-presented and newly diagnosed pulmonary TB patients aged ≥ 15 years who delayed > 30 days without healthcare provider consultation, and controls were patients with similar inclusion criteria but who consulted a healthcare provider within 30 days of illness; 216 cases sex-matched with 226 controls were interviewed using a pre-tested questionnaire. Hierarchical analysis was done using conditional logistic regression. Results: After multilevel analysis, pastoralism, rural residence, poor knowledge of TB symptoms and expectation of self-healing were individual-related determinants. Mild-disease and manifesting a single symptom were disease-related, and >1 h walking distance to nearest facility and care-seeking from traditional/religious healers were health system-related determinants of patient delay > 30 days [p < 0.05]. Conclusion: Expansion of TB services, mobile screening services, and arming community figures to identify and link presumptive cases can be effective strategies to improve case detection in pastoral settings.
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Lemoh, Chris N., Samia Baho, Jeffrey Grierson, Margaret Hellard, Alan Street, and Beverley-Ann Biggs. "African Australians living with HIV: a case series from Victoria." Sexual Health 7, no. 2 (2010): 142. http://dx.doi.org/10.1071/sh09120.
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Background: This research aimed to describe the characteristics of African-born Victorians living with HIV, identify associations with delayed HIV diagnosis and describe their response to combination antiretroviral therapy (cART). Methods: A case series of African-born adults living with HIV in Victoria was conducted. Data was collected in interviews and reviews of case notes. Associations with delayed HIV diagnosis (CD4 below 200 cells µL–1 at diagnosis and/or AIDS within 3 months of HIV diagnosis) were explored using univariate regression. AIDS-defining illnesses and response to cART were described. Results: Fourteen males and six females were included. Ten were born in the Horn of Africa (nine in Ethiopia). Sixteen had sexual exposure (12 heterosexual; four male-to-male sex). Seven reported acquiring HIV in Australia. Median CD4 count at diagnosis was 145 cells µL–1. Ten had delayed HIV diagnosis, of whom eight were born in the Horn of Africa. Delayed HIV diagnosis was associated with birth in the Horn of Africa (odds ratio: 11.56). Nine had a diagnosis of AIDS, including three cases of tuberculosis, three of Pneumocystis jiroveci pneumonia and two of cerebral toxoplasmosis. Eighteen had received cART, of which 16 achieved virological suppression and 15 achieved a CD4 count above 200 cells µL–1. Clinical failure and virological failure occurred in seven and five cases, respectively. Conclusions: HIV prevention strategies for Victoria’s African communities should address HIV exposure in Australia. Ethiopian-born Victorians with HIV appear to be at particular risk of delayed diagnosis. Response to cART in this series was comparable to that observed in other industrialised countries.
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Taddese, Boja D., Daniel M. Desalegn, Abay S. Misganaw, Kumera T. Kitila, Tinsae Kidanemariam Hailu, and Abraham T. Bika. "Diagnostic Performance of Xpert MTB/RIF Assay Versus Ziehl-Neelsen Method for the Diagnosis of Pulmonary Tuberculosis in Addis Ababa, Ethiopia." Open Microbiology Journal 12, no. 1 (November 30, 2018): 390–96. http://dx.doi.org/10.2174/1874285801812010390.
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Background: Worldwide Tuberculosis (TB) is the ninth leading cause of death from a single infectious agent, positioning on top of Human Immuno Deficiency Virus (HIV) and it is still an eminently serious public health problem. In developing countries, Ziehl-Neelsen (ZN)-stained sputum smear microscopy is the most widely used diagnostic method in diagnosing Pulmonary Tuberculosis (PTB). This study was aimed to compare the diagnostic performances of ZN-method with Xpert MTB/RIF assay for the diagnosis of PTB in Addis Ababa, Ethiopia. Methods: Facility-based cross-sectional study design was conducted from September 2016 to June 2017 on a total of 244 sputum samples collected from presumptive TB patients. The L-J sputum culture was used as a gold standard to compare the diagnostic performances of Xpert MTB/RIF assay and ZN-methods. Kappa values were analyzed by using statistical package for Social Science (SPSS) version 20 software at 95% Confidence Interval (CI). The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of ZN-stained sputum smear microscopy and Xpert MTB/RIF assay were calculated against the gold standard. Results: The Sensitivity, Specificity, PPV and NPV of ZN-stained sputum smear microscopy were 68.38%, 95.28%, 93.02% and 76.58% respectively, while for Xpert MTB/ RIF assay were 88.89%, 81.89%, 81.89% and 88.89% respectively. The results of the two diagnostic approaches were concordant with the gold standard with a kappa value of ZN 0.650 and 0.743 for Xpert MTB/RIF assay. Conclusion: This study concludes that the sensitivity of Xpert MTB/RIF assay was better than ZN-stained direct sputum smear microscopy for the diagnosis of pulmonary tuberculosis.
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Ayalaw, Sualiha Gebeyaw, Kefyalew Addis Alene, and Akilew Awoke Adane. "Incidence and Predictors of Tuberculosis among HIV Positive Children at University of Gondar Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study." International Scholarly Research Notices 2015 (May 26, 2015): 1–6. http://dx.doi.org/10.1155/2015/307810.
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Background. The aim of this study was to determine the incidence of tuberculosis and its predictors among HIV positive children. Methods. A six-year retrospective follow-up study was conducted among HIV infected children aged less than 15 years. Life table was used to estimate the cumulative probability of tuberculosis free survival. Cox proportional hazards model was used to identify predictors of tuberculosis. Results. A total of 271 HIV positive children were followed for six years and produced 1100.50 person-years of observation. During the follow-up period 52 new TB cases occurred. The overall incidence density of TB was 4.9 per 100 PY. Inappropriate vaccination [AHR: 8.03 (95% CI; 4.61–13.97)], ambulatory functional status [AHR: 1.99 (95% CI; 1.04–3.81)], and having baseline anemia [AHR: 2.23 (95% CI; 1.19–4.15)] were important predictors of time to TB occurrence. Conclusion. TB incidence rate was high. Early diagnosis and treatment of anemia and strengthening immunization program would reduce the risk of TB occurrence.
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Ayalew, Yibeltal Estemech, Fikadu Ambaw Yehualashet, Worknesh Akanaw Bogale, and Mengistu Berhanu Gobeza. "Delay for Tuberculosis Treatment and Its Predictors among Adult Tuberculosis Patients at Debremarkos Town Public Health Facilities, North West Ethiopia." Tuberculosis Research and Treatment 2020 (September 19, 2020): 1–8. http://dx.doi.org/10.1155/2020/1901890.
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Background. Delay in the diagnosis and treatment of tuberculosis exacerbates the disease and clinical outcomes. It further enhances transmission of the infection in the society as well as increased the severity of the illness and raised rate of mortality. Objectives. The major goal of this study is to determine the magnitude of delays in tuberculosis treatment and factors affecting tuberculosis treatment among adult tuberculosis patients at Debremarkos town, North West Ethiopia, 2018. Methods. Institution-based cross-sectional study design was employed. Systematically selected 300 adult TB patients were recruited to the study. The study was conducted at Debremarkos town public health facilities from March 1 to April 30, 2018. Logistic regression models were fitted to identify the predicting variables and control confounder’s of the outcome variables. P value ≤ 0.05 with 95% CI was considered as an indicator for the presence of statistically significant association. The result revealed that the median total delay was 23 days (IQR: 19-28 days). The median patient and health system delays were 20 days (IQR: 15-20 days) and 4 days (IQR: 3-5 days), respectively. Tuberculosis patients living in a rural area were 1.14 times more likely to delay for the TB treatment (AOR: 1.141, 95% CI (1.106, 2.608)). Patients who were unable to read and write have almost two times a chance of being delayed (AOR: 2.350, 95% CI (1.630, 2.608)). Monthly income of patients has found another predictor for delay; patients with low monthly income were about six times more likely to delay for TB treatment (AOR: 6.375, 95% CI: (1.733, 23.440)). Those TB patients who had visiting traditional healers before arrival to health facilities were about 2.7 times more likely to delay for TB treatment(AOR: 2.795, 95% CI (1.898, 8.693)). Conclusion and Recommendation. The significant proportion of delays in tuberculosis treatment was found in this study. Living in the rural area, unable to read and write, lower monthly income, and visiting traditional healers were found independent predictors of TB treatment delay. The regional and zonal health administrator shall design various awareness creation mechanisms to educate the public about timely initiation of tuberculosis treatment.
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Tadesse, Mulualem, Gemeda Abebe, Danie Yilma, Ludwig Apers, Bouke De Jong, and Leen Rigouts. "PO 8168 CLINICAL UTILITY OF XPERT MTB/RIF ASSAY FOR THE DIAGNOSIS OF EXTRAPULMONARY TUBERCULOSIS IN ETHIOPIA." BMJ Global Health 4, Suppl 3 (April 2019): A20.2—A20. http://dx.doi.org/10.1136/bmjgh-2019-edc.50.
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BackgroundThe diagnosis of extrapulmonary tuberculosis (EPTB) is often made on clinical suspicion alone, and many people receive the wrong diagnosis leading to unnecessary TB treatment or poor outcomes from untreated EPTB. In this study, we evaluated the clinical utility of the Xpert MTB/RIF assay on routinely collected extra-pulmonary specimens in Ethiopia.MethodsThis study was carried out at Jimma University Specialized Hospital, Southwest Ethiopia from September 2015 to June 2017. Extra-pulmonary specimens were collected from 572 patients clinically suspected of suffering from EPTB. All specimens were tested for TB by smear-microscopy, culture and Xpert MTB/RIF. The diagnostic accuracy of Xpert MTB/RIF was calculated compared to a composite reference standard (CRS), composed of liquid culture and anti-TB treatment response.ResultsIn total, 572 extra-pulmonary specimens (279 lymph node, 159 pleural, 80 peritoneal, 45 cerebrospinal and 9 pericardial fluids) were tested. The pooled sensitivity and specificity of Xpert MTB/RIF were calculated to be 91% and 90.6% respectively when compared to culture. The pooled sensitivity of Xpert MTB/RIF was decreased to 75% and the specificity was improved to 98% when Xpert MTB/RIF was compared to the CRS. The sensitivities among the specimen types differed markedly. The highest sensitivity was documented for lymph node (90%), moderate sensitivity for cerebrospinal (53%), while the sensitivity was lowest for pleural (30%) and peritoneal (32%) fluids. Xpert MTB/RIF, in addition, detected rifampicin resistance in 13 patients in perfect agreement with line probe assay.ConclusionOur study showed that Xpert MTB/RIF is likely to be of greatest utility when testing lymph node specimens. A negative Xpert MTB/RIF result on fluid specimens does not exclude the diagnosis of EPTB and patients with a high clinical probability of EPTB should be started on anti-TB treatment.
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Saravanan, Muthupandian, Selam Niguse, Mahmud Abdulkader, Ephrem Tsegay, Haftamu Hailekiros, Atsbeha Gebrekidan, Tadele Araya, and Arivalagan Pugazhendhi. "Review on emergence of drug-resistant tuberculosis (MDR & XDR-TB) and its molecular diagnosis in Ethiopia." Microbial Pathogenesis 117 (April 2018): 237–42. http://dx.doi.org/10.1016/j.micpath.2018.02.047.
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Tiruye, Agumas, Shu-Hua Wang, Baye Gelaw, Jordi Torrelles, and Baye Gelaw. "Accuracy of the Color Plate Microcolony Detection for the Diagnosis of Mycobacterium tuberculosis Complex in Northwest Ethiopia." American Journal of Clinical Pathology 150, suppl_1 (September 21, 2018): S125—S126. http://dx.doi.org/10.1093/ajcp/aqy101.301.
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Arja, Asrat, Wanzahun Godana, Hadiya Hassen, and Biruk Bogale. "Patient delay and associated factors among tuberculosis patients in Gamo zone public health facilities, Southern Ethiopia: An institution-based cross-sectional study." PLOS ONE 16, no. 7 (July 30, 2021): e0255327. http://dx.doi.org/10.1371/journal.pone.0255327.
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Background Delayed tuberculosis diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Therefore, the main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia. Methods A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of the study area were selected randomly and 255 TB patients who were ≥18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Patient delay was analyzed using the median as the cut-off value. Multivariable logistic regression analysis was fitted to identify factors associated with patient delay. A p-value of ≤ 0.05 with 95% CI was considered to declare a statistically significant association. Results The median (inter-quartile range) of the patient delay was 30 (15–60) days. About 56.9% of patients had prolonged patients’ delay. Patient whose first contact were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: 2.38; 95%CI: 1.36, 4.17) and body mass index (BMI) categories of underweight (AOR: 1.74; 95%CI: 1.01, 3.00) were independently associated with increased odds of patient delay. However, having good knowledge about TB (AOR: 0.44; 95% CI: 0.26, 0.76) significantly reduce patients’ delay. Conclusion In this study, a significant proportion of patients experienced more than the acceptable level for the patient delay. Knowledge about TB, the first action to illness, presenting symptoms, and BMI status were identified factors associated with patient delay. Hence, raising public awareness, regular training, and re-training of private and public healthcare providers, involving informal providers, and maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long delays in the management of TB.
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Ameni, Gobena, Glyn Hewinson, Abraham Aseffa, Douglas Young, and Martin Vordermeier. "Appraisal of Interpretation Criteria for the Comparative Intradermal Tuberculin Test for Diagnosis of Tuberculosis in Cattle in Central Ethiopia." Clinical and Vaccine Immunology 15, no. 8 (May 21, 2008): 1272–76. http://dx.doi.org/10.1128/cvi.00114-08.
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ABSTRACT Accurate detection and removal of infected cattle, using immunodiagnostic tests such as the comparative intradermal tuberculin (CIDT) test, are the basis of control strategies for bovine tuberculosis (TB). According to the Office des Internationale Epizooties recommendation, the cutoff point for positivity of the CIDT test, calculated as the difference between skin thicknesses after bovine tuberculin (B) and avian tuberculin (A) injections (B − A), is >4 mm. This cutoff point is used worldwide, although it is likely that local conditions influence test performance. Thus, this study was formulated to determine CIDT test cutoff points applicable to cattle in central Ethiopia. Receiver operating characteristic analysis was performed for the CIDT test, using data from 186 Bos indicus (zebu) and Bos taurus (Holstein) cattle. Detailed postmortem examination for the presence of TB lesions was used to define disease status. At a cutoff of >2 mm, CIDT test sensitivity was 69% (95% confidence interval [95% CI], 58.5 to 79%), while it was 59% (95% CI, 49 to 69%) at a cutoff of >4 mm. In contrast, specificities of the CIDT test at these two cutoff values were identical, at 97% (95% CI, 89 to 100%). Thus, the maximum sensitivity of the CIDT test can be realized using a >2-mm cutoff without affecting specificity. The apparent prevalence was significantly (χ2 = 13.56; P < 0.001) higher at a cutoff of >2 mm (16.0%; n = 5,424) than at a >4-mm cutoff (13.5%; n = 5,424). Nonetheless, no significant difference (χ2 = 2.15; P = 0.14) in true prevalence was observed at a cutoff of >2 mm (19.6%) and at a cutoff of >4 mm (18.5%). Thus, our study demonstrates the importance of defining local, relevant cutoff values to maximize test sensitivity, and we suggest the application of the >2-mm cutoff for testing of cattle in central Ethiopia.
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Shibabaw, Agumas, Baye Gelaw, Holden Kelley, Joan Miquel Balada-Llasat, Carlton Evans, Shu-Hua Wang, Jordi B. Torrelles, and Belay Tessema. "Accuracy of the color plate micro-colony detection for the diagnosis of Mycobacterium tuberculosis complex in Northwest Ethiopia." Tuberculosis 114 (January 2019): 54–60. http://dx.doi.org/10.1016/j.tube.2018.11.007.
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Ramos, José Manuel, Mario Pérez-Butragueño, Gabriel Tisiano, Tafese Yohannes, Francisco Reyes, and Miguel Górgolas. "Evaluation of Ziehl–Neelsen smear for diagnosis of pulmonary tuberculosis in childhood in a rural hospital in Ethiopia." International Journal of Mycobacteriology 2, no. 3 (September 2013): 171–73. http://dx.doi.org/10.1016/j.ijmyco.2013.04.007.
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Tegbaru, Belete, Dawit Wolday, Tsehaynesh Messele, Mengistu Legesse, Yared Mekonnen, Frank Miedema, and Debbie van Baarle. "Tuberculin Skin Test Conversion and Reactivity Rates among Adults with and without Human Immunodeficiency Virus in Urban Settings in Ethiopia." Clinical and Vaccine Immunology 13, no. 7 (July 2006): 784–89. http://dx.doi.org/10.1128/cvi.00098-06.
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ABSTRACT To investigate whether low CD4+ T-cell counts in healthy and human immunodeficiency virus (HIV)-infected Ethiopians influence tuberculosis (TB) immunological memory, tuberculin skin test (TST) conversion and reactivity rates were investigated among adults with and without HIV infection in urban settings in Ethiopia. Reaction to the TST was analyzed with purified protein derivative by the Mantoux technique. A total of 1,286 individuals with TST results of ≥5-mm (n = 851) and ≤4-mm (n = 435) induration diameters were included. Individuals with ≤4-mm induration sizes were followed up for 21.4 ± 9.5 months (mean ± standard deviation) to observe skin test conversion. The overall TST reactivity (≥5-mm induration diameter) was 66.2% (n = 851). Reactivity was significantly lower among HIV-positive persons (40.5%) than among HIV-negative persons (68.7%) (P < 0.001). Of the above persons, 32 incident TB patients were checked for their TST status 13.05 ± 11.1 months before diagnosis and reactivity was found among 22 (68.7%) of them. Of the TST-negative persons with 0- to 4-mm indurations who were followed up for 3 years, the conversion rate to positivity was 17.9/100 person-years of observation (PYO) (14.4/100 PYO and 18.3/100 PYO in HIV-positive and -negative persons, respectively). Despite lower absolute CD4+ T-cell numbers in Ethiopians, higher TST conversion and reactivity rates show the presence of a higher rate of latent TB infection and/or transmission. The lower TST positivity rate before a diagnosis of TB disease showed the lower sensitivity of the test. This indicates the need for other sensitive and specific diagnostic and screening methods to detect TB infection, particularly among HIV-positive persons, so that they can be given prophylactic isoniazid therapy.
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Getahun, Gedeyon, Tilahun Beyene, and Lakew Abebe. "Tuberculosis’ Total Health care system and patient side diagnosis and Treatment Delay and Associated Factors Among Pulmonary Tuberculosis Patients At Hadiya Zone Public Health Facilities, Southern Ethiopia." Journal of Drug Delivery and Therapeutics 9, no. 1-s (February 15, 2019): 214–28. http://dx.doi.org/10.22270/jddt.v9i1-s.2327.
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Background: Delay in TB treatment is significant to both disease prognoses at the individual level and within the community. Even though studies conducted in TB treatment delay there is result inconsistencies due to differences in culture, environment and infrastructure.
Objective: the aim of the study is to assess the tuberculosis treatment Delay and associated factor among pulmonary tuberculosis patients.
Method: Facility based cross sectional study triangulated by Qualitative study was employed on 340 PTB patients in Hadiya zone public health facilities. Three woredas and health facilities were selected by Simple random sampling method. DOTS user at the beginning of data collection was consecutively recruited in to the study until the intended sample size was fulfilled. Multivariable binary Logistic regression was used. A P-value < 0.05 at 95 % CI was considered statistical significance between dependent and predictors variables.
Result: Among 340 PTB patients enrolled in the study, of which 49.1% experienced patient delay, 30% health system delay and 49.8% total delay. Unable to read and write, Poor knowledge of TB (AOR 3.96, 95% CI (2.28 6.86), self-treatment (AOR: 2, 95% CI (1.14, 3.93), financial constraint (AOR: 2.092, 95% CI (1.11, 3.945) , Visiting two or more health care providers (AOR: 3.40, 95% CI (1.910 – 6.07), prolonged referral (AOR: 3.004, 95% CI (1.59, 5.67) were independent predictors of delay.
Conclusion: Nearly half of the total delay was contributed by patient delay. Unable to read and write, Poor knowledge of TB, self-treatment, financial constraints, prolonged referral, several visit of health care provider of two or more and ever used other drugs rather than Anti-TB drugs were found to have association with patient delay and health system delay.
Keywords: Tuberculosis treatment delay, PTB, patient delay and health system delay, Hadiya zone, Ethiopia.
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Getachew, Konjit, Tamrat Abebe, Abebaw Kebede, Adane Mihret, and Getachew Melkamu. "Performance of LED Fluorescence Microscopy for the Diagnosis of Pulmonary Tuberculosis in HIV Positive Individuals in Addis Ababa, Ethiopia." Tuberculosis Research and Treatment 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/794064.
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Background. Despite its lower sensitivity, smear microscopy remains the main diagnostic method for pulmonary tuberculosis (PTB) in resource-limited countries as TB culturing methods like LJ (Lowenstein-Jensen) are expensive to use as a routine base. This study aimed to evaluate the performance of LED-FM for the diagnosis of PTB in HIV positive individuals.Methods. Cross-sectional study was conducted in Zewditu Memorial Hospital and Teklehaimanot Health Center HIV/ART clinics in Addis Ababa, Ethiopia. Each sample was stained with ZN and Auramine O staining and examined with bright-field microscope and LED-FM microscope, respectively. LJ culture was used as a reference.Results. Out of 178 study participants, twenty-four (13.5%) patients were confirmed as positive for MTB with LJ culture. The yield of ZN microscopy and LED-FM in direct and concentrated sample was 3.9%, 8.4%, 6.2%, and 8.4%, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of direct ZN microscopy were 29.2%, 100%, 100%, and 90.1%, respectively, and of LED-FM microscopy in direct sputum sample were 62.5%, 100%, 100%, and 94.5%, respectively.Conclusion. LED-FM has better sensitivity for the diagnosis of PTB in HIV positive individuals as compared to conventional ZN microscopy. LED-FM can be used as an alternative to conventional ZN microscopy.
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Kassa, Getahun Molla, Mehari Woldemariam Merid, Atalay Goshu Muluneh, and Haileab Fekadu Wolde. "Comparing the impact of genotypic based diagnostic algorithm on time to treatment initiation and treatment outcomes among drug-resistant tuberculosis patients in Amhara region, Ethiopia." PLOS ONE 16, no. 2 (February 18, 2021): e0246938. http://dx.doi.org/10.1371/journal.pone.0246938.
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Background To end Tuberculosis (TB) by 2030, early detection and timely treatment of Drug-Resistant Tuberculosis (DR-TB) is vital. The role of rapid, accurate, and sensitive DR-TB diagnostic tool is indispensable to accelerate the TB control program. There are evidence breaks in the time difference and its effect on treatment outcomes among different DR-TB diagnostic tools in Ethiopia. This article aimed to compare the different DR-TB diagnostic tools with time pointers and evaluate their effect on the treatment outcomes. Method We performed a retrospective chart review of 574 DR-TB patients from September 2010 to December 2017 to compare the impact of molecular DR-TB diagnostic tests (Xpert MTB/RIF, Line Probe Assay (LPA), and solid culture-based Drug Susceptibility Testing (DST)) on time to diagnosis, treatment initiation, and treatment Outcomes. Kruskual-Wallis test was employed to assess the presence of a significant difference in median time among the DR-TB diagnostic tests. Chi-Square and Fisher exact tests were used to test the presence of relations between treatment outcome and diagnostic tests. Result The data of 574 DR-TB patients were included in the analysis. From these, 321, 173, and 80 patients were diagnosed using Xpert MTB/RIF, Line Probe Assay (LPA), and solid culture-based DST, respectively. The median time in a day with (Interquartile range (IQR)) for Xpert MTB/RIF, LPA, and solid culture-based DST was from a first care-seeking visit to diagnosis: 2(0, 9), 4(1, 55), and 70(18, 182), from diagnosis to treatment initiation: 3(1, 8), 33(4, 76), and 44(9, 145), and from a first care-seeking visit to treatment initiation: 4(1, 11), 3(1, 12) and 76(3.75, 191) respectively. The shorter median time was observed in the Xpert MTB/RIF followed by the LPA, and this was statistically significant with a p-value <0.001. There was no statistically significant difference concerning treatment outcomes among the three DST tests. Conclusion Xpert MTB/RIF can mitigate the transmission of DR-TB significantly via quick diagnosis and treatment initiation followed by LPA as equating to the solid culture base DST, particularly in smear-positive patients. However, we didn’t see a statistically significant impact in terms of treatment outcomes. Xpert MTB/RIF can be used as the first test to diagnose DR-TB by further complimenting solid culture base DST to grasp the drug-resistance profile.
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Adenager, Getinet Shewaseged, Fessahaye Alemseged, Henok Asefa, and Amanuel Tesfay Gebremedhin. "Factors Associated with Treatment Delay among Pulmonary Tuberculosis Patients in Public and Private Health Facilities in Addis Ababa, Ethiopia." Tuberculosis Research and Treatment 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/5120841.
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Background. Early detection and diagnosis of tuberculosis (TB) and the timely commencement of antituberculosis (anti-TB) treatment are the parts of efficient tuberculosis prevention and control program. Delay in the commencement of anti-TB treatment worsens the prognosis and increases the risk of death and the chance of transmission in the community and among health care workers. Objective. To assess tuberculosis treatment delay and associated factors among pulmonary TB patients in Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 public and 10 private health facilities that provide TB treatment. The data were collected from 425 newly registered pulmonary TB patients using pretested structured questionnaire from April to June 2012. Data were entered in EPI info version 3.5.1 and analyzed using SPSS version 16.0. Findings. The median durations of a patient, health care system, and total treatment delays were 17, 9, and 35 days, respectively. Overall 179 (42.1%), 233 (54.8%), and 262 (61.6%) of patients experienced patient delay, health care system delay, and total treatment delay, respectively. Distance more than 2.5 km from TB treatment health facility [AOR = 1.6, 95% CI (1.1–2.5)] and the presence of TB-associated stigma [AOR = 2.1, 95% CI (1.3, 3.4)] indicate higher odds of patient delay, whereas, being unemployed, patients with the hemoptysis symptom complain indicated lower odds of health care system delay [AOR = 0.41, 95% CI (0.24, 0.70)] and [AOR = 0.61 (0.39, 0.94)], respectively. Conclusions. A significant proportion of clients experienced patient and health care system delay. Thus, there is a need for designing and implementing appropriate strategies to decrease the delays. Efforts to reduce delays should give focus on integrating prevention programs such as active case detection and expanding access to TB care.
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Seyoum, Berhanu, Meaza Demissie, Alemayehu Worku, Shiferaw Bekele, and Abraham Aseffa. "Prevalence and Drug Resistance Patterns ofMycobacterium tuberculosisamong New Smear Positive Pulmonary Tuberculosis Patients in Eastern Ethiopia." Tuberculosis Research and Treatment 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/753492.
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The study aimed at determining the prevalence and drug resistance patterns ofMycobacterium tuberculosisamong new smear positive pulmonary tuberculosis patients visiting TB diagnosis and treatment facilities at selected health facilities in eastern Ethiopia. A cross-sectional study was conducted between October 2011 and May 2013. A total of 408 new adult pulmonary TB patients (≥ 18 years) were enrolled in this study. Three consecutive sputum samples (spot, morning, and spot) were collected from each patient and transported to the Armauer Hansen Research Institute TB laboratory located in Addis Ababa for culture on Lowenstein Jensen slant media. DST was performed on 357 (87.5%) of the patient samples for isoniazid (H), rifampicin (R), ethambutol (E), and streptomycin (S) using the standard proportion method. The rate of resistance to any one drug was 23%. Any resistance to H, S, R, and E was 14%, 11.5%, 2.8%, and 0.3%, respectively. The highest proportion of monoresistance was observed against H (9.5%). MDRTB was detected in 1.1% of the patients. Any drug resistance was associated with HIV infection (COR = 3.7, 95% CI 1.905–7.222) (P= 0.000). Although the prevalence of MDRTB is relatively low in the study area, high prevalence of H resistance is a serious concern demanding close monitoring. Expanding diagnostic capacity for mycobacterial culture and DST is a vital step in this regard.
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Abayneh, Mengistu, Shewangizaw HaileMariam, and Abyot Asres. "Low Tuberculosis (TB) Case Detection: A Health Facility-Based Study of Possible Obstacles in Kaffa Zone, Southwest District of Ethiopia." Canadian Journal of Infectious Diseases and Medical Microbiology 2020 (May 16, 2020): 1–9. http://dx.doi.org/10.1155/2020/7029458.
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Background. In Ethiopia, the national TB case detection rate is becoming improved; still some districts are not able to meet their case detection targets which leads to ongoing spread of TB infections to family members and communities. This study was intended to assess possible obstacles contributing to low TB case detection in Kaffa zone, Southwest Ethiopia. Methods. A cross-sectional descriptive study involving qualitative and quantitative data was conducted from Mar. to Sep. 2019. Sociodemographic characteristics and data on duration of cough, whether sputum smear microscopy was requested or not, and data on TB knowledge and health care-seeking practice were collected from outpatients. Health care delivery barrier for TB case detection was also explored by using in-depth interview and FGD of health staff. Results. From 802 outpatients with coughing for 2 or more weeks of duration, 334 (41.6%) of them were not requested to have TB microscopic diagnosis. Of these, 11/324 (3.4%) of them were positive for TB after sputum smear microscopy. Only 24.2% of the outpatients were aware as they have had health education on TB disease. Twenty-eight percent of patients perceived that TB was due to exposure to cold air, and 13.5% could not mention any sign or symptom of TB. Amazingly, 54.2% of them did not have any information as current TB diagnosis and treatment is free. Thirty-five percent of the patients were taking antibiotics before visiting the health facility. The interrupted supply of TB diagnostic reagents, frequent electricity interruption, shortage of trained TB care providers, weak health information system, and weak active case finding practice were explored as the factors contributing to low TB case detection. Conclusion. Interrupted functioning of diagnostic centers, shortage of trained care providers, limited active TB case finding practice, weak health information system, and inadequate knowledge and health care-seeking practice of the patients were identified as contributors for low TB case detection. Thus, improving functioning of diagnostic centers, active TB case finding activities, and expanding health education on TB disease will help to improve TB case detection in the districts.
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Shiferaw, Melashu Balew, Mulusew Alemneh Sinishaw, Desalegne Amare, Genetu Alem, Dawit Asefa, and Eveline Klinkenberg. "Prevalence of active tuberculosis disease among healthcare workers and support staff in healthcare settings of the Amhara region, Ethiopia." PLOS ONE 16, no. 6 (June 11, 2021): e0253177. http://dx.doi.org/10.1371/journal.pone.0253177.
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Background Health care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia. Methods A cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology. Results A total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18–24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals). Conclusions The magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.
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Worku, Mesfin, Mulualem Agonafir, Mubarek A. Yassin, Mohammed A. Yassin, Daniel G. Datiko, Sally Theobald, and Luis E. Cuevas. "Use of Xpert MTB/RIF for the Identification of TB and Drug Resistance Among Smear-Negative and Re-Treatment Cases in Rural Areas of Ethiopia." Open Microbiology Journal 13, no. 1 (June 30, 2019): 188–92. http://dx.doi.org/10.2174/1874285801913010188.
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Introduction: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality worldwide. A key contributor to this burden is poor diagnosis as only 60% of new pulmonary tuberculosis (TB) cases in Africa are ever detected. Therefore, this study aimed to assess the feasibility of Xpert MTB/RIF test implementation in the region, and the performance of the assay to increase case detection on the selected rural health care setting. Objective: To assess the feasibility of Xpert MTB/RIF test implementation in the rural health care setting in Southern Ethiopia. Methods: Two Xpert MTB/RIF machines were brought in 2012 through TB REACH project. It was placed at Yirgalem hospital and at Aletawondo health centre. The instruments were installed after formal training was provided to laboratory technologists for three days. We collected sputum sample from participants who repeatedly had negative smear microscopy and those who had not responded to first-line anti-TB drugs. Result: Of the total participants tested, 1828 have valid result (MTB-, MTB+/RIF-, MTB+/RIF+, MTB+/RIF Indeterminate). From the participants with valid results, 217 (11.9%) were Xpert-positive of which were 165 (9.0%) RIF-negative, 6 (0.3%) RIF-indeterminate and 46 (2.5%) RIF-positive. Among TB suspects with previous treatment history and positive by Xpert, RIF resistance was detected in 10 (2.2%). From the new TB suspects with positive Xpert, RIF resistance was detected in 29 (2.7%). All cases identified were linked with TB/MDR-TB treatment centers. Conclusion: Xpert provides an additional tool for the diagnosis of TB and drug resistance, with almost 12% of new and retreatment cases obtaining information that is useful for clinical management. To enhance its efficient utilisation, operational challenges should be minimized particularly in relation to availing robust alternative power source.
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Gidey, Kidu, Desalegn Belay, Berhane Yohannes Hailu, Tesfaye Dessale Kassa, and Yirga Legesse Niriayo. "Visceral Leishmaniasis Treatment Outcome and Associated Factors in Northern Ethiopia." BioMed Research International 2019 (August 21, 2019): 1–7. http://dx.doi.org/10.1155/2019/3513957.
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Background. Visceral leishmaniasis (VL), one of the most neglected tropical diseases, is placing a huge burden on Ethiopia. Despite the introduction of antileishmanial drugs, treatment outcomes across regions are variable due to drug resistance and other factors. Thus, understanding of VL treatment outcomes and its contributing factors helps decisions on treatment. However, the magnitude and the risk factors of poor treatment outcome are not well studied in our setting. Therefore, our study was designed to assess treatment outcomes and associated factors in patients with VL. Materials and Methods. A cross-sectional study was conducted in VL patients admitted between June 2016 and April 2018 to Ayder Comprehensive Specialized Hospital, Tigray, Northern Ethiopia. Data was collected through chart review of patient records. Logistic regression analysis was used to identify factors associated with poor treatment outcome. Results. A total of 148 VL patients were included in the study. The mean age (SD) of the patients was 32.86 (11.9) years; most of them (94.6%) were male patients. The proportion of poor treatment outcome was 12.1%. Multivariable logistic regression analysis showed that long duration of illness (> four weeks) (adjusted odds ratio (AOR): 6.1 [95% confidence interval (CI); 1.3-28.6], p=0.02) and concomitant tuberculosis (TB) infection (AOR 4.6 [95% CI; 1.1-19.1], p=0.04) were the independent predictors of poor treatment outcome. Conclusions. Poor treatment outcome was observed in a considerable proportion of VL patients. Long duration of illness and coinfection with TB were associated with poor VL treatment outcome. Hence, early diagnosis and effective prompt treatment are important to improve treatment outcomes among VL patients. Special attention should also be given in the treatment of VL/TB coinfected patients in our setting.
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Chemeda, Alemu, Tamrat Abebe, Gobena Ameni, Adane Worku, and Adane Mihret. "Utility of urine as a clinical specimen for the diagnosis of pulmonary tuberculosis in people living with HIV in Addis Ababa, Ethiopia." Journal of Clinical Tuberculosis and Other Mycobacterial Diseases 17 (December 2019): 100125. http://dx.doi.org/10.1016/j.jctube.2019.100125.
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Araya, Bezalem Tesfaye, Kirubel Eshetu Ali, Dereje Assefa Geleta, Saba Gebremichael Tekele, and Kassu Desta Tulu. "Performance of the Abbott RealTime MTB and RIF/INH resistance assays for the detection of Mycobacterium Tuberculosis and resistance markers in sputum specimens." PLOS ONE 16, no. 5 (May 12, 2021): e0251602. http://dx.doi.org/10.1371/journal.pone.0251602.
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Background The Abbott RealTime MTB is an assay for the detection of Mycobacterium tuberculosis (MTB) complex DNA from respiratory specimens in combination with the Abbott RealTime RIF/INH assay for the detection of genetic resistance markers for isoniazid (INH) and rifampicin (RIF) from MTB positive isolates. Hence, this study aimed to evaluate the performance of the Abbott RealTime MTB and RIF/INH assays. Methods A cross-sectional study was conducted on 289 study subjects presumptive to have pulmonary tuberculosis at Nigist Eleni Mohammed Memorial Hospital, South Ethiopia from April 2017 to June 2018. Two morning expectorated sputum specimens were collected from each study participant. One sample was tested directly by Xpert MTB/RIF assay at Nigist Eleni Mohammed Memorial Hospital and the other sample was used for smear microscopy, TB culture, Abbott RealTime MTB, and Abbott RealTime INH/RIF assays at International Clinical Laboratories, Addis Ababa, Ethiopia. The diagnostic performance of the Abbott RealTime MTB and INH/RIF assays were calculated against MGIT liquid culture and phenotypic drug susceptibility testing (DST) as the gold standard. Results For the detection of MTB the Abbott RealTime MTB assay exhibited sensitivity 92.4% (95% CI 83.6–96.9), specificity 95.4% (95% CI 91.1–97.7), PPV 89.0% (95% CI 79.7–94.5) and NPV 96.9% (95% CI 93.0–98.7). For the detection of RIF resistance MTB, Abbott RealTime MTB RIF/INH concurred with phenotypic DST and Xpert MTB/RIF, while for the detection of INH resistance MTB, the sensitivity, specificity, PPV and NPV of the Abbott MTB RIF/INH assay was 84.2% (95% CI 60.4–96.6), 100% (95% CI 89.7–100), 100% and 91.9% (95% CI 80.0–96.9), respectively. Conclusions The Abbott RTMTB and RIF/INH assays revealed high sensitivity and specificity in MTB diagnosis and provided reliable INH and RIF resistance profiles. This assay has a similar diagnostic performance to the Xpert MTB/RIF assay with the advantages of high-throughput.
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Tekalign, Samson, Cherinet Adera, Margriet Den Boer, Hirpha Miecha, Ashenafi Zewde, Dagnachew Mulugeta, Tesfahun Bishawu, et al. "Clinical features and treatment outcomes of visceral leishmaniasis patients admitted to three centers in Oromia, Ethiopia." Journal of Infection in Developing Countries 14, no. 06.1 (June 30, 2020): 42S—47S. http://dx.doi.org/10.3855/jidc.11731.
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Introduction: In three health care facilities in the Oromia region, the aim of this study is to report on 1) the number of VL cases registered over time (2013-2018) and 2) the clinical profile, type of treatment used and response to treatment.
Methodology: A retrospective cohort study was conducted among all VL cases admitted with a diagnosis of VL.
Results: A total of 434 VL cases were registered at the three health facilities, but patient files were available for only 188. Most (51.6%) were children and only three presented with VL relapse. 78 (41.5%) of the 188 patients presented within one month of symptom onset. Concurrent severe acute malnutrition (27.1%), tuberculosis (6.4%) and malaria (6.4%) were common. There were only two cases with HIV coinfection. Fourty-three percent were treated with antimonials, 34% with antimonials combined with paromomycin and 23% with AmBisome. Amongst the 188 patients with patient files there were no deaths and one treatment failure. Six months outcome data were however missing for all. Aggregated data from the 434 VL cases reported three deaths, two treatment failures and one relapse.
Conclusions: Children were most commonly affected, suggesting long-term endemicity. While short-term outcomes are encouraging, long-term follow-up data are required.
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Jibril, Yasmin, Gezahegne Mamo, Ahmed Issa, Aboma Zewude, and Gobena Ameni. "Appraisal of interpretation criteria for the single intra-dermal comparative cervical tuberculin test for the diagnosis of tuberculosis in dromedary camels in Ethiopia." Tropical Animal Health and Production 50, no. 7 (May 2, 2018): 1665–70. http://dx.doi.org/10.1007/s11250-018-1610-y.
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Ouedraogo, Abdoul Risgou, Ingvar Sanyu, Lamla Nqwata, Ermias Amare, Stephen Gordon, Jane Ardrey, Kevin Mortimer, and Jamilah Meghji. "Knowledge, attitudes, and practice about bronchiectasis among general practitioners in four African cities." Journal of the Pan African Thoracic Society 2 (May 25, 2021): 94–100. http://dx.doi.org/10.25259/jpats_5_2021.
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Objectives: The survey was to determine Knowledge, attitude, and practices around bronchiectasis, as a starting point for the development of guidelines for care in African Countries. Materials and Methods: This survey was administered to non-specialist physicians in urban health centers in Burkina Faso, Uganda, South Africa, and Ethiopia. Data were anonymized and analyzed at an individual level by country and health-care setting. Results: A total of 388 participants were recruited from Ouagadougou (75/388, 19.3%), Kampala (85/388, 21.9%), Johannesburg (74/388, 19.3%), and Addis Ababa (154/388, 39.6%). Median age was 30 years, and 66% were male, with a median of 3-year medical experience. Knowledge about the definition, clinical presentation, and diagnosis of disease was good. However, guidelines for local practice were largely absent. Wide variation was reported in diagnostic and management practices. Physicians recognized the need for guidelines and further training. Conclusion: This study highlighted the lack of local guidelines for bronchiectasis care in these settings and marked variation in approaches to investigation, diagnosis, and management within and between sites. Context-appropriate guidelines for bronchiectasis care in Sub-Saharan Africa are needed. These must be informed by local epidemiology, should reflect locally available resources and comorbidities including tuberculosis-disease, and should be codeveloped with local practitioners.
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Sorsa, Abebe, Degu Jerene, Solomon Negash, and Ashenafi Habtamu. "Use of Xpert Contributes to Accurate Diagnosis, Timely Initiation, and Rational Use of Anti-TB Treatment Among Childhood Tuberculosis Cases in South Central Ethiopia." Pediatric Health, Medicine and Therapeutics Volume 11 (May 2020): 153–60. http://dx.doi.org/10.2147/phmt.s244154.
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Geluk, Annemieke, John S. Spencer, Kidist Bobosha, Maria C. V. Pessolani, Geraldo M. B. Pereira, Sayera Banu, Nadine Honoré, et al. "From Genome-Based In Silico Predictions to Ex Vivo Verification of Leprosy Diagnosis." Clinical and Vaccine Immunology 16, no. 3 (January 28, 2009): 352–59. http://dx.doi.org/10.1128/cvi.00414-08.
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ABSTRACT The detection of hundreds of thousands of new cases of leprosy every year suggests that transmission of Mycobacterium leprae infection still continues. Unfortunately, tools for identification of asymptomatic disease and/or early-stage M. leprae infection (likely sources of transmission) are lacking. The recent identification of M. leprae-unique genes has allowed the analysis of human T-cell responses to novel M. leprae antigens. Antigens with the most-promising diagnostic potential were tested for their ability to induce cytokine secretion by using peripheral blood mononuclear cells from leprosy patients and controls in five different areas where leprosy is endemic; 246 individuals from Brazil, Nepal, Bangladesh, Pakistan, and Ethiopia were analyzed for gamma interferon responses to five recombinant proteins (ML1989, ML1990, ML2283, ML2346, and ML2567) and 22 synthetic peptides. Of these, the M. leprae-unique protein ML1989 was the most frequently recognized and ML2283 the most specific for M. leprae infection/exposure, as only a limited number of tuberculosis patients responded to this antigen. However, all proteins were recognized by a significant number of controls in areas of endemicity. T-cell responses correlated with in vitro response to M. leprae, suggesting that healthy controls in areas where leprosy is endemic are exposed to M. leprae. Importantly, 50% of the healthy household contacts and 59% of the controls in areas of endemicity had no detectable immunoglobulin M antibodies to M. leprae-specific PGL-I but responded in T-cell assays to ≥1 M. leprae protein. T-cell responses specific for leprosy patients and healthy household contacts were observed for ML2283- and ML0126-derived peptides, indicating that M. leprae peptides hold potential as diagnostic tools. Future work should concentrate on the development of a sensitive and field-friendly assay and identification of additional peptides and proteins that can induce M. leprae-specific T-cell responses.