Epidemiology of multidrugresistant tuberculosis mdr tb in ethiopia. A total of 439 medical records belonging to mdr tb and non mdr tb patients managed in public health centres from january 2008 to december 2011 were analysed. Costs faced by multidrug resistant tuberculosis patients. Determinants of drugresistant tuberculosis in southern ethiopia. However, 350 to 450 mdr tb cases are notified annually. Ethiopia, tb treatment gaps remain especially among mdr tb cases 12. Peters hospital in ethiopia national mdr tb specialized hospital revealed that 15. Ethiopia indonesia kazakhstan tb mdr tb tb mdr tb tb mdr tb patients who lost their job 76% 72% 26% 53% 31% 41% patients hospitalized for tb 36% 82% 33% 62% 98% 100% median duration of hospitalization days 40 80 7.
The aim of this study was to describe the characteristics of patients with mdr. The number of mdr tb patients in each district was the dependent variable. To determine risk factors of mdr tb patients in amhara national regional state, ethiopia. Tuberculosis tb remains a major global health problem and ranks as the second leading cause of death among deaths caused by infectious diseases worldwide. The burden of preextensively and extensively drugresistant. Risk factors for multidrug resistant tuberculosis patients in. In most developing countries, including in ethiopia, the magnitude and risk factors of drugresistant tuberculosis drtb are expected to be.
The mortality among mdr tb patients is high, for instance a study conducted at st. According to 2018 global tb report, 117,705 tb cases were reported in the country. In 2015, the treatment success rate for multidrugresistant. The implementation of tb prevention and control interventions is guided by the five year. However, tb diagnosis in ethiopia has been mainly based on sputum smear microscopy. Rifampicin resistance was lower than 2% in new cases. Download the document who regional office for africa. Spread and control of multidrug resistance tuberculosis. Kncv is an international center of expertise for tb control that promotes effective, efficient, innovative and sustainable tuberculosis control strategies in a national and international context. Ethiopia has been one of the highest tb burden countries with respective incidence and prevalence rates of 247 and 470. The prevalence of mdr tb in ethiopia reported in 2018 was 0. Assessment of the survival status and risk factors for the. Improving tb detection rates and further reducing the burden of disease in ethiopia will require optimization of the current laboratory system as well as the introduction of new.
The socioeconomic impact of multidrug resistant tuberculosis. M ultidrug resistant tuberculosis mdr tb is a public health crisis and a global health security risk car rying grave consequences for those affected. Ethiopia is among the 30 high tb, hiv and mdr tb burden countries, with annual. In ethiopia the mdr tb prevalence based on the 2005 nationwide survey was 1. Updated knowledge of the magnitude of mdr tb is so substantial to allocate resources. Multidrug resistant tuberculosis mdr tb is becoming a major threat to tuberculosis control programs in ethiopia. Multi drug resistant tuberculosis mdr tb is an emerging challenge for tb control programs globally. This was an ecological study, using mdr tb data from northwest ethiopia aggregated at the district level. Casecontrol study was conducted from may 20 to january 2014.
Current treatment of multidrug resistant tuberculosis in. Between 2012 and 2015, patient enrollment rate increased twelvefold while at the same time achieving treatment success rate of 75% and cure rate of 65%. The duration of longer mdr tb regimens 31 section 4. Pdf prevalence of multidrugresistant tuberculosis and.
Job description kncv tuberculosis foundation is an international nonprofit organization dedicated to the fight against tuberculosis tb, the first deadliest infectious disease in the world. According to report of who 2017, tb is one of the leading infectious causes of death in ethiopia claiming the life of more than 30 thousand people annual. The emergence of mdr tb is a threat for the populations of. Global epidemiology of tuberculosis and progress toward. Pdf tuberculosis burden in ethiopia from 1990 to 2016. Mdrtb cases in ethiopia was reported to be 68% who, 2016. Ethiopia ranks 7 th among the worlds 22 high tb burden countries. Review open access multidrugresistant tuberculosis in. Survival status and treatment outcome of multidrug resistant. Multidrug resistant tuberculosis mdr tb is becoming a major threat to tuberculosis control programs in. A concurrent mixed methods design with quantitative dominance was used to investigate treatment outcomes of patients with mdr tb and its determinants. Ethiopia is one of the 30 mdr tb highburden countries, with an estimated prevalence rate of 1.
Overall, an estimated 558,000 incident cases of rr or mdr tb occurred in 2017, representing 5. Ethiopia is one of the countries with high mdr tb burden. Dec 27, 2018 ethiopia is one of the 30 high burden countries for tuberculosis including drug resistant tuberculosis. Globally, as of 2018, the world health organisation who has reported that nearly 50% of mdr tb patients were successfully treated but there were still high rates of mortality and loss of patients to followup 1. Poor treatment outcome and its predictors among drugresistant. Tuberculosis, leprosy and tbhiv who world health organization. Ethiopia ranks 7th among the worlds 22 high tb burden countries. Who consolidated guidelines on drugresistant tuberculosis. Epidemiological evidence of mdr tb in ethiopia the who report in 20 indicated that 450,000 new cases of mdr tb and 170,000 deaths due to mdr tb occurred globally in 2012.
The global response to mdr tb and xdr tb enrolment on mdr tb treatment blue squares, 20092011. Although the availability of shortcourse regimens as firstline anti tuberculosis drugs, the emergence of drugresistant mycobacterium tubercu. Spatial patterns of multidrug resistant tuberculosis and. Tuberculosis treatment outcomes in ethiopia from 2003 to 2016. Expanding ambulatory care to treat drugresistant tb in ethiopia. Funding available for mdr tb has increased from usd 0. Research findings from different parts of ethiopia 234 5 6. Ranking of sear countries by mdr tb incidence, 2015 1. Phd thesis improving tuberculosis control in ethiopia. According to report of who 2017, tb is one of the leading infectious causes of death in ethiopia claiming the life of more than 30 thousand people annually. Accordingly, through etbe the implementing partners will find and treat 484,540 new tb patients and 14,357 mdr tb patients and achieve treatment success rates tsrs of at least 95% for drugsensitive ds tb and 85% for drugresistant dr tb and an ltbi treatment target of 450,000. In ethiopia, the programmatic management of drugresistant tb pmdt was started in 2009 in response to the first 45 mdr tb patients identified at st.
Out of 766 articles, 23 were found to meet eligibility criteria and. Mdr tb, or resistant to other firstline tb medicines polyresistant or secondline tb medicines e. The objective of the study was to investigate risk factors for mdr tb in addis ababa. With the exception of one hospital in addis ababa, which initiated a pilot mdrtb treatment program in 2009, only. To combat tb in ethiopia, usaid has been investing in increasing the availability of and demand for tb and mdr tb prevention, care, and treatment services for many years and has contributed to the countrys progress towards eliminating the disease. Improving tb detection rates and further reducing the burden of disease in ethiopia will require optimization of. Up to date, the mdr tb treatment outcome is not sufficiently understood in ethiopia. Risk factors for multidrug resistant tuberculosis in addis. Risk factors for multidrug resistant tuberculosis patients in amhara. Implementation guideline for genexpert mtbrif assay in.
Sep 01, 2016 globally, the prevalence of mdr tb was reported to be 3. Ethiopia is one of the 27 high mdr tb burden countries and ranks third in the continent with an estimated 2100 annually notified mdr tb cases 7, 8. A qualitative assessment of challenges to tuberculosis. An estimated 480 000 people developed mdr tb in 2014 and 190 000 people died as a result of it. Abstract multidrug resistant tuberculosis mdr tb is becoming a major challenge of the tuberculosis tb control program in ethiopia. According to recent evidence from a rural area in ethiopia, twothird of the infectious tb patients are not detected tadesse et. Ethiopia is one of tb, tbhiv, and multidrug resistant tuberculosis mdr tb high burden country globally. More than half of presumptive multidrugresistant cases. Multidrug resistant tuberculosis mdr tb is an emerging challenge for tb control programs globally. Surveillance of drug resistance tuberculosis based on. A total of 6 n6 patients with mdr tb participated in the study, 74 54%. To assess poor treatment outcomes and their predictors among drug resistant tuberculosis patients treated in ethiopia. Apr 06, 2021 tuberculosis tb is one of several preventable diseases that remains a heavy burden in ethiopia. Genexpert implementation guideline ethiopia challenge tb.
National guidelines on drug resistant tuberculosis management. Ethiopia the world health organization who listed ethiopia as one of the 30 high tuberculosis tb, tb hiv, and drugresistant tb dr tb burden countries. Based on a recent metaanalysis report, the pooled estimate of mdr tb among new and previously treated cases was 2% 1 to 2% and 15% 12 to 17%,respectively. The most powerful predictor of the emergence of mdr tb reported in ethiopia is previous exposure to anti tb drug treatment. This quantitative, descriptive study investigated risk factors for mdr tb in addis ababa, ethiopia. Tuberculosis, ethiopia, qualitative assessment, isoniazid. The first national surveillance data during the 20032005 study periods reported 1. Ethiopia sustain anti malaria interventions and eliminating plasmodium falciparum malaria in 50 districts ccm malaria, incl. To determine risk factors of mdr tb patients in amhara national.
Although mdr tb is a growing concern in resource limited countries like ethiopia, it is largely underreported, compromising control efforts. In addition, the burden of mdr tb in ethiopia is increasing. Pdf multidrug resistant tuberculosis in ethiopian settings and its. Based tuberculosis prevalence survey vi as ethiopia is one of the 22 highest tb burden countries in the world, federal ministry of health of ethiopia is implementing tb prevention and control program at all level of the health facility. Ethiopia remains one of the high tb and mdr tb burden countries where tb remains a significant cause of morbidity and mortality 11, 12. In total 406 mdr tb patients and 197 other tb patients were included in the survey. Download pdf annals of clinical microbiology and antimicrobials. Full text determinants of drugresistant tuberculosis in. Total costs for diagnosis and current treatment episode for tb. Sep 27, 2018 background the programmatic management of multidrugresistant tuberculosis mdr tb is entirely based on a who recommended longterm, 1824 month lasting treatment regimen. The surge of mdr tb has been compounding the problem further. Ministry of health and the ethiopian public health institute. Review on emergence of drugresistant tuberculosis mdr.
Another challenge to tb control in ethiopia is the emergence of multidrug resistant tb mdr tb. In ethiopia, the incidence of mdr tb strains is a continuing challenge to the tb control program. Multidrugresistant mycobacterium tuberculosis and associated risk. Tb hiv and mdr tb burden countries with an estimated tb incidence of 164 per 100,000 population of drug susceptible tb. Expanding ambulatory care to treat drugresistant tb in. Comparative crosssectional study was conducted to determine the risk factors for mdr tb in addis ababa. Prevalence of tuberculosis, multidrug resistant tuberculosis. The mdr tb patients were interviewed once, at the health facility. Prevalence of multi drug resistant tuberculosis among. Information concerning the true extent of the problem of mdr tb. Northwest ethiopia has a variety of geographical features, including the highest mountain and the largest lake in the country, and a geographical boundary with both sudan. Multidrug resistant tuberculosis in ethiopian settings and.
The composition of longer mdr tb regimens 19 section 3. Risk factors for multidrug resistant tuberculosis patients. Risk factors for multidrug resistant tuberculosis in. The mdr tb dataset included individuallevel demographic, laboratory and clinical variables. Federal democratic republic of ethiopia ministry of health. The main purpose of this study was to determine the prevalence of mdr tb and associated factors in ethiopia. Ethiopia launched new guideline for reaching missed. Out of 766 articles, 23 were found to meet eligibility criteria and included in this. Prevalence of multidrug resistant mycobacterium tuberculosis. Multidrug resistant tuberculosis mdr tb is becoming a major public health problem in ethiopia. Pdf background multidrugresistant tuberculosis mdr tb has continued to be a challenge for tuberculosis tb control globally. However, growing evidence shows that low treatment success rate and high rates of adverse events are associated with this regimen.
Ethiopia is 15th among the 27 mdr tb highburden countries, with an estimated 5,200 cases occurring each year 9. Ethiopia is the third largest and populous country in africa. Tb strains may be susceptible or resistant to isoniazid i. Definition of treatment outcomes for drug resistant tuberculosis. As a result, tb deaths have dropped significantly as. The major causes of tb morbidity and mortality are a lack of access to early diagnosis and treatment services, coinfections with other infectious diseases such as hivaids and limited capacity to diagnose and manage multidrug resistant mdr tb. Mdrtb tropical diseases, travel medicine and vaccines. The experience of scaling up a decentralized, ambulatory. Use of the standardized shorter mdr tb regimen 35 section 5. Only 50% of the mdr tb patients in the 2012 cohort of detected cases were successfully treated. Prevalence of multidrugresistant tuberculosis and associated. There are estimated around 1500 cases of dr tb annually.
Start of antiretroviral therapy in patients on secondline antituberculosis regimens 45. Pdf background efforts to control the global burden of tuberculosis tb have been jeopardized by the rapid evolution of multidrug resistant. Worldwide, tuberculosis tb is the leading cause of death from a single infectious disease agent 1 and the leading cause of death among persons living with human immunodeficiency virus hiv infection, accounting for approximately 40% of deaths in this population 2. In these guidelines and elsewhere, mdr tb and rr tb cases are often grouped together as mdr rr tb. May 01, 2017 this is the first large scale implementation experience of the ambulatory mdr tb treatment model in ethiopia, through which it was possible to achieve rapid expansion of mdr tb services. These mdr tb data were aggregated to the district level to obtain the number of. An estimated 230,000 persons died of either rr or mdr tb case fatality 41%. Tuberculosis treatment outcomes in ethiopia from 2003 to. The data were collected by staff from the university of gondar mdr tb treatment centre. Annually 20002500 mdr tb cases are estimated to occur among the notified pulmonary tb cases. In indonesia patients were interviewed at two mdr tb referral hospitals on java island persahabatan hospital in jakarta and dr moe. Multidrug resistant tuberculosis mdrtb has become an increasing threat.
However, between 2007 and 2012, a total of 65,422 mdr tb cases were reported by 15 countries. Mdr tb is more likely to be fatal and is as much as 100 times more costly to treat who, 1998a. There were 156 800 estimated new tb cases, 24 080 deaths, 1456 mdr tb cases and 10 192 tb hiv coinfected cases in 2019 1. The impact of mdr tb is much worse in lowincome countries such as ethiopia, where the socioeconomic status of the people is low, tb burden is high, and wellequipped health care facilities are limited. The treatment of mdr tb in ethiopia started recently in tb specialized hospital and expanded to mdr tb treatment. Peters and alertinaddisababaanduniversityofgondar hospital in gondar. Monitoring patient response to mdr tb treatment using culture 41 section 6. Survival status and treatment outcome of multidrug. Mar 19, 2018 moreover, ethiopia is also one of the 27 countries with a high burden of multidrugresistant tuberculosis mdr tb. Ethiopia expand and sustain tb, tb hiv and mdr tb interventions in ethiopia ccm tb full proposal ghana towards a generation free of hivaids in ghana ccm hivaids, incl.
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