Challenge TB, Management Sciences for Health, Addis Ababa, Ethiopia.
Management Sciences for Health, Arlington, USA.
BMC Public Health. 2020 Mar 6;20(1):302. doi: 10.1186/s12889-020-8290-z.
Tuberculosis (TB) is a major public health problem. Its magnitude the required interventions are affected by changes in socioeconomic condition and urbanization. Ethiopia is among the thirty high burden countries with increasing effort to end TB. We aimed to describe the case notification rate (CNR) for urban tuberculosis (TB) and estimate the percentage of TB patients who are not from the catchment population.
This cross-sectional study used data from TB registers from 2014/15 to 2017/18. We calculated the CNR and treatment success rate for the study area.
Of 2892 TB cases registered, 2432 (84%) were from Adama City, while 460 (16%) were from other sites. The total TB CNR (including TB cases from Adama and other sites) was between 153 and 218 per 100,000 population. However, the adjusted TB CNR (excluding cases outside Adama City) was lower, between 135 and 179 per 100,000. Of 1737 TB cases registered, 1652 (95%) were successfully treated. About 16% of TB cases notified contributing to CNR of 32 per 100,000 population is contributed by TB cases coming from outside of Adama city. The CNR of 32 per 100,000 population (ranging from 18 to 46 per 100,000) for Adama City was from the patients that came from the surrounding rural areas who sought care in the town.
Although the TB CNR in Adama City was higher than the national CNR, about one-fifth of TB cases came from other sites-which led to overestimating the urban CNR and underestimating the CNR of neighboring areas. TB programs should disaggregate urban TB case notification data by place of residence to accurately identify the proportion of missed cases.
结核病（TB）是一个主要的公共卫生问题。其严重程度和所需干预措施受到社会经济状况和城市化变化的影响。埃塞俄比亚是 30 个结核病高负担国家之一，正在加大努力终结结核病。我们旨在描述城市结核病（TB）的病例报告率（CNR），并估计未从监测人群中发现的结核病患者比例。
本横断面研究使用了 2014/15 年至 2017/18 年期间的结核登记处数据。我们计算了研究区域的 CNR 和治疗成功率。
在登记的 2892 例结核病病例中，2432 例（84%）来自阿达玛市，460 例（16%）来自其他地点。总结核病 CNR（包括来自阿达玛和其他地点的结核病病例）在每 100,000 人口 153 至 218 例之间。然而，调整后的结核病 CNR（不包括阿达玛市以外的病例）较低，在每 100,000 人口 135 至 179 例之间。在登记的 1737 例结核病病例中，1652 例（95%）成功治疗。报告的结核病病例中有 16%（每 100,000 人口 32 例）是来自阿达玛市以外的结核病病例，这导致每 100,000 人口 32 例的 CNR （每 100,000 人口 18 至 46 例）。阿达玛市的这一 CNR 是来自周边农村地区的患者在城镇寻求治疗的结果。
尽管阿达玛市的结核病 CNR 高于全国 CNR，但约五分之一的结核病病例来自其他地点，这导致高估了城市 CNR，并低估了邻近地区的 CNR。结核病规划应按居住地对城市结核病病例报告数据进行细分，以准确确定漏报病例的比例。
