Kefyalew Addis Alene|Kerri Viney|Darren J. Gray|Emma S. McBryde|Maereg Wagnew|Archie C. A. Clements
Mapping tuberculosis treatment outcomes in Ethiopia
Australian National University|Australian National University|Australian National University|Australian Institute of Tropical Health and Medicine|James Cook University|Government of Ethiopia|Federal Ministry of Health|Curtin University
tuberculosis tb leading cause death infectious disease ethiopia killing 30 thousand people every year study aimed determine whether rates poor tb treatment outcome varied geographically across ethiopia district zone levels whether variability associated socioeconomic behavioural health care access climatic conditionsa geospatial analysis conducted using national tb data reported health management information system hmis period 20152017 prevalence poor tb treatment outcomes calculated dividing sum treatment failure death loss followup total number tb patients binomial logistic regression models computed spatial analysis performed using bayesian framework estimates parameters generated using markov chain monte carlo mcmc simulation geographic clustering assessed using getisord gi statistic global local morans statisticsa total 223244 tb patients reported 722 districts ethiopia study period 63556 285 cured 139633 624 completed treatment 6716 30 died 1459 07 treatment failure 12200 55 lost followup overall prevalence poor tb treatment outcome 90 range 158 hotspots clustering poor tb treatment outcomes detected districts near international borders afar gambelia somali regions cold spots detected oromia amhara regions spatial clustering poor tb treatment outcomes positively associated proportion population low wealth index 101 95ci 10 101 proportion population poor knowledge tb 102 95ci 101 103 higher annual mean temperature per degree celsius 115 95 ci 108 121this study showed significant spatial variation poor tb treatment outcomes ethiopia related underlying socioeconomic status knowledge tb climatic conditions clinical public health interventions targeted hot spot areas reduce poor tb treatment outcomes achieve national endtb strategy targets