Department of Oncology, Faculty of Medicine, Lund University, Lund, Sweden.
Department of Cellular and Molecular Biology, Faculty of Sciences, Addis Ababa University Addis Ababa, Ethiopia.
PLoS One. 2021 Oct 12;16(10):e0242446. doi: 10.1371/journal.pone.0242446. eCollection 2021.
Mycobacterium tuberculosis (TB) is the deadliest disease that claims millions of deaths globally. Ethiopia is among the countries heavily hit by the disaster. Despite the effective directly observed treatment and TB infection control (TBIC) measures provided by the world health organization (WHO), the rate of new cases increased daily throughout the country. Healthcare workers (HCWs) are at highest risk serving without having the necessary facility in place while overcrowding of patients exacerbated TB transmission. The study aimed to assess TBIC implementation and analyze case notification rate (CNR) of smear-positive pulmonary TB in the selected health facilities at Dale district, Sidama Zone, Southern Ethiopia.
Seven health care facilities have been visited in the study area and smear-positive pulmonary TB notification rate was determined retrospectively during the years 2012 to 2014. Data on smear positive test results and demographic characteristics were collected from the TB unit registries. A structured questionnaire, facility survey, and observation checklists were used to assess the presence of TBIC plans at the health care facilities.
The overall case notification rate of smear-positive pulmonary tuberculosis was 5.3% among all 7696 TB suspected patients. The odds of being diagnosed with smear-positive TB were 24% more in males than in females (adj OR = 1.24, 95% CI: (1.22, 1.55). Moreover, in the study area, only 28% of the facilities have been practiced TB infection control and 71% of the facilities assigned a focal person for the TBIC plan. The implementation of environmental control measures in the facilities was ranged between 16-83%. N95 particulate respirators were found only in 14% of the facilities.
TB CNR in Dale district was low. Moreover, implementations of TBIC in Dale district health facilities were poor when the survey was done. Hence, urgent measures should be taken to reverse the burden of TB.
结核分枝杆菌（TB）是全球致死人数最多的疾病。埃塞俄比亚是受灾最严重的国家之一。尽管世界卫生组织（WHO）提供了有效的直接观察治疗和结核感染控制（TBIC）措施，但该国各地的新病例数量仍在每天增加。在没有必要设施的情况下提供服务的医护人员（HCWs）处于最高风险之中，而患者的过度拥挤加剧了结核病的传播。本研究旨在评估 TBIC 的实施情况，并分析在埃塞俄比亚南部锡达马地区戴尔区选定卫生机构中，涂阳肺结核的病例报告率（CNR）。
在研究区域访问了 7 个卫生保健机构，并在 2012 年至 2014 年期间回顾性确定了涂阳肺结核的通知率。从 TB 单位登记册中收集了涂阳测试结果和人口统计学特征的数据。使用结构化问卷、设施调查和观察清单评估了卫生保健设施中 TBIC 计划的存在情况。
在所有 7696 例疑似结核病患者中，涂阳肺结核的总病例报告率为 5.3%。与女性相比，男性被诊断为涂阳结核病的可能性高 24%（调整比值比=1.24，95%置信区间：（1.22, 1.55）。此外，在所研究的地区，只有 28%的设施实施了结核感染控制，71%的设施指定了一名人员负责 TBIC 计划。设施中环境控制措施的实施率在 16-83%之间。仅在 14%的设施中发现了 N95 颗粒物呼吸器。
戴尔区的结核病例报告率较低。此外，在进行调查时，戴尔区卫生机构的 TBIC 实施情况较差。因此，应采取紧急措施来减轻结核病的负担。
