Dabaro Desalegn
Sidama Zone Health Department, Hawassa, South Ethiopia.
J Clin Tuberc Other Mycobact Dis. 2017 Aug 12;9:1-4. doi: 10.1016/j.jctube.2017.08.003. eCollection 2017 Dec.
Tuberculosis is one of the deadly communicable diseases which claim the lives of millions in the world. Early case detection and prompt treatment cures the patients, breaks the transmission and improves the control program.
The aim of this study was to investigate the factors affecting tuberculosis case detection in Kersa District, south west Ethiopia.
Facility based cross sectional study design was employed in four directly observed treatment short course service providing public health centers. Three hundred eighty four patient folders were reviewed. In-depth interviews was conducted with 18 health care workers including heads of health centers, tuberculosis focal persons, clinicians, laboratory technicians, tuberculosis program coordinator and head of health office.
Significant number, 135(35.2%) of tuberculosis suspects were not requested for microscopic examination of sputum smear, the laboratory results 21(8.4%) of requested patients were not recorded in both patient folders and laboratory registers. Only 10 (4.4%) of those examined and recorded were smearing positive. Participants described that the shortage and irregular supply of acid fast bacilli reagents and consumable, inadequate infrastructures, frequent electricity interruption, shortage of trained care providers, negligence of care providers, weakness of laboratory quality assurance system and poor health information use culture were major factors for low case identification.
The resource shortage, electricity interruption, low commitment of care providers, weak quality assurance practice and poor health information use culture were major factors for low tuberculosis case identification and should be considered.
结核病是一种致命的传染病，在全球导致数百万人死亡。早期病例发现和及时治疗可治愈患者、阻断传播并改善防控计划。
本研究旨在调查影响埃塞俄比亚西南部克萨区结核病病例发现的因素。
在四个提供直接观察短程治疗服务的公共卫生中心采用基于机构的横断面研究设计。审查了384份患者档案。对18名医护人员进行了深入访谈，包括卫生中心负责人、结核病专员、临床医生、实验室技术人员、结核病项目协调员和卫生办公室负责人。
相当数量的135名（35.2%）结核病疑似患者未被要求进行痰涂片显微镜检查，在被要求检查的患者中，有21名（8.4%）的实验室结果未记录在患者档案和实验室登记册中。在接受检查并记录的患者中，只有10名（4.4%）涂片呈阳性。参与者表示，抗酸杆菌试剂和耗材短缺且供应不规律、基础设施不足、频繁停电、缺乏训练有素的医护人员、医护人员疏忽、实验室质量保证体系薄弱以及健康信息使用文化不佳是病例识别率低的主要因素。
资源短缺、停电、医护人员投入度低、质量保证措施薄弱以及健康信息使用文化不佳是结核病病例识别率低的主要因素，应予以考虑。
