tb survey 2011 preliminary resultaarc.gov.et › images › demo1 › ethiopia collection ›...
TRANSCRIPT
![Page 1: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/1.jpg)
Ethiopian National TB Prevalence survey 2010‐2011 Preliminary Result
Zeleke Alebachew, MpH/EpidemiologyNational Survey Coordinator
FMOH/EHNRI
October 27,2011Lille, France
![Page 2: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/2.jpg)
Outline of presentation
• Introduction • Objectives• Result • Strength and Limitation of the study• Major findings • implication to the program • Strength and limitation
![Page 3: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/3.jpg)
1. Introduction
SomaliOromiya
AfarAmhara
SNNPR
Tigray
Gambella
Benishangul GumuzDire
HARERawa
Addis Ababa
N
EW
S
810,Districts
(76% - rural Pon,16%-Urban and 8%-Pastoralist)‐ Projected Pon for 2010 = 79,731,054
and 15,022 Kebeles
‐ Administratively divided in to : 9 Regions and 2 City Administrations,
####
#
>15 years=55%
![Page 4: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/4.jpg)
Introduction
• Prevalence of TB all forms = 585/100000 (WHO 2009 report)
• Prevalence of smear positive TB =284/100000(2008 WHO estimate)
• Incidence Rate SS+ =163/100000 (WHO 2009 estimate)
• 7th high TB burden country in the world• 3rd high TB burden country in Africa
![Page 5: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/5.jpg)
Introduction…
TB control Program performance of EthiopiaProgram achievement Global target• Current SS+ CDR=36% 70%• TSR =84% 85%• SS+ NR = 57/100,000• NR all forms = 183/100,000
![Page 6: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/6.jpg)
Rationale of TB prevalence survey for Ethiopia
• No study is available at population level• Between 2007&2008, WHO estimate of SS+ TB increased from 152 to 168/100,000.
• The case detection rate remain steady between 32‐34 % against the expected 70% global target.
• Evidence based approach is essential for plan and decision making.
• TB prevalence survey is one of the most effective tools to monitor the impact of the program.
![Page 7: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/7.jpg)
Trend of WHO SS+ TB Estimate Vs Case Detection Rate (CDR) in Ethiopia-FMoH1999/00-2009/10 (1992-2002EC)
31 34 36 36 38 35 32 3235 34 36
0
20000
40000
60000
80000
100000
120000
140000
1999
/0020
00/01
2001
/0220
02/03
2003
/0420
04/05
2005
/0620
06/07
200/0
820
08/09
2009
/10
SS
+ TB
Est
imat
e
0
20
40
60
80
100
CDR
(%)
Estimated SS+ Cases SS+ TB CDR
![Page 8: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/8.jpg)
Countries where surveys are recommended (Approved by Task Force Meeting, Dec 2007)
21 global focus countries36 additional countries that met basic criteria
Note: Ethiopia was added to the global focus countries in 2009
![Page 9: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/9.jpg)
Cambodia Malaysia Indonesia Eritrea Thailand Philippines Bangladesh Myanmar Cambodia Ghana Kenya
Viet Nam
Viet Nam China Nigeria Malawi Indonesia
Ethiopia
Uganda
Rwanda Mozambique
S. AfricaNepal
Tanzania Philippines
Thailand
Bangladesh
0
1
2
3
4
5
6
7
8
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013-15
Num
ber o
f sur
veys
Non Global Focus country Africa Asia
21 Global Focus countries identified by WHO
Global progress, prevalence surveys
Pakistan
![Page 10: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/10.jpg)
2. Objective
1. To determine the prevalence of smear positive TB
2. To determine the prevalence of culture positive TB
3. To determine the prevalence of symptoms suggestive of TB
![Page 11: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/11.jpg)
3. Method
Cross-sectional survey
Multistage cluster sampling
Stratified : Urban, rural & pastoral populations
Sample size: 46,514 (aged > 15)
Clusters: 85 (Urban: 14; Rural:63;Pastoral:8)
cluster size: 548 subjects
![Page 12: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/12.jpg)
List of selected districts
![Page 13: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/13.jpg)
Sampling StagePPS
85( 63 R, 14 U &8 P)
PPS1 in each district ,total 85
Random selectionn blocks, 550 individuals
Woreda(District)
Kebele
Household blocks
![Page 14: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/14.jpg)
Screening
![Page 15: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/15.jpg)
Bacteriologic examination
• Two sputum (morning and spot)requested from survey TB suspects : smear done for both spot and morning and culture done for morning and rarely spot processed incase of morning not submitted.
• Smear microscopy using LED FM • Culture using solid media
![Page 16: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/16.jpg)
4. Result
‐ Survey operation started on October 2,2010 and completed on June 25,2011
‐ A total of19,267 house hold members has been included in the study
‐ Census done for 95092 individuals(46186( 49.6) male and 47906(50.4) Female.
‐ Total eligible invited to the study =51667
![Page 17: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/17.jpg)
Population pyramid of Ethiopia and survey participants
‐30 ‐20 ‐10 0 10 20 30
15‐24
25‐34
35‐44
44‐54
55‐64
65 and above
‐30 ‐20 ‐10 0 10 20 30
15‐24
25‐34
35‐44
44‐54
55‐64
65 and above
Male
Female
![Page 18: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/18.jpg)
Participation rate by sex
Sex ParticipationTotal Eligibleparticipated(%) Refused(%) Absent(%)
Male 21819(88.6) 1(0) 2803(11.4) 24623Female 24878(92) 2(0) 2164(8) 27044
Total 46697(90.4) 3(0) 4967(9.6) 51667
![Page 19: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/19.jpg)
Participation rate by strata
Strata
ParticipationTotal eligible
invitedParticipated(
%) Refused AbsentUrban 7490(86.5) 0 1164(13.5) 8654Rural 34952(91.5) 3(0) 3226(9.5) 381829Pastoral 4255(88.1) 0 577(11.9) 4832Total 46697(90.4) 3(0) 4967(9.6) 51667
![Page 20: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/20.jpg)
Eligible study population51,667 (54%)
Participants (screened by at least one method)
46,697 (90%)
Total number of individuals eligible for sputum examination:6,078 (13%)
‐ 806 (13%) eligible by both screening methods‐ 2,219 (36%) eligible by symptoms screening only‐ 3,012 (50%) eligible by chest X‐ray screening only‐ 41 (1%) exempted/refused CXR & symptomatic2
At least 1 sputum specimen collected
5,864 (96%)
Both sputum specimens collected 5,606 (92%)
Participants symptoms screening 46,697 (100%)
Participants chest X‐ray screening46,548 (99.7%)
Participants screened by both methods
46,548 (99.7%)
Individuals enumerated in census95,092 Ineligible individuals:
‐ 41,125 children‐ 2,300 adult non‐resident
Non participants:‐ 4,967 not present‐ 3 present but no consent
Also requested sputa:‐ 1 ineligible
‐ 87 refused CXR‐ 62 exempted 1 from CXR
Both smear results available
At least 1 smear result available
Culture result available5,770 (99%)
Both specimens examined with smear5,598 (99%)
At least 1 specimen examined with smear
5,863 (∼100%)
Specimen examined with culture
5,809 (99%)
![Page 21: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/21.jpg)
Smear Positive Study Cases =47• 61 showed at least one slide AFB smear positive screened by LED Fluorescent MS. – 33 Definite Cases: Isolation of Mycobacterium Tuberculosis by culture= study case
– 14 Probable Cases: 8 subjects with 2 smear positive slides, 6 subjects with 1 smear positive slide with CXR consistent with TB by a panel reading= study case
– 13 Possible Cases: Non‐study case: One slide positive without any other evidence to suggest TB
– 1 NTM: Isolation of Mycobacterium other than TB without co‐isolation of Mycobacterium tuberculosis
![Page 22: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/22.jpg)
Smear Negative Culture Positive Study Cases = 63
63 Smear Negative MTB Culture Positive Subjects – 59 Definite Case with CXR consistent with TB
– 4 Probable Case: "MTB isolates 10 colonies or more" without CXR consistent with TB
: Isolations of MTB from two tubes
– 0 Possible Case: MTB isolates less than 10 colonies without CXR consistent with TB = Non Study Case
![Page 23: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/23.jpg)
sputum panel Tx Sy final decision
totalsp1
sp2 c
TBBE Norma
l
TB
sug. consist healed on ex definit
eprobabl
epossi
ble
+ + + 27 1 5 19 27 27
+ + 6 1 6 6
+ + 0
+ 41 17 1 4 1(ex/on)
3 29 59 4 63
+ + 5 1 1 1 1(ex/on)
1 4 8 8
+ 2 2 3 5 2 3 6 4 10 14
+ 1 1 2 1 4 2 3 5
82 21 5 8 7 3 12 63 92 18 13 123
*BE: Bronchial Echtasis
![Page 24: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/24.jpg)
Smear and culture TB casesSmear‐positive: 47‐ 25 identified by both screening methods‐ 2 identified by symptoms screening only‐ 20 identified by chest X‐ray screening only (Note: All smear positive culture conformed cases were identified by CXR screening)Smear‐negative, culture‐positive: 63‐ 21 identified by both screening methods‐ 9 identified by symptoms screening only‐ 33 identified by chest X‐ray screening only
Positive bacteriological result: 110‐ 46 identified by both screening methods‐ 11 identified by symptoms screening only‐ 53 identified by chest X‐ray screening only
![Page 25: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/25.jpg)
Prevalence of smear positive TB and bacteriologicaly confirmed TB by sex
among participants
P of S+ TB per 100000 (95% CI)
P of S+ and/or C+ TB per 100000 (95% CI)
Male 123 (75–171) 287 (201–374)
Female 83 (44–122) 232 (163–301)
Total 105(72,138) 259(205,314)
![Page 26: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/26.jpg)
Point Prevalence of smear positive TB by strata among participants
StrataSmear Positive
Total Participa
nts
P of Smear positive
TB/100000,(95%CI)
Urban 5 7490 77(0,159)Rural 35 34952 103(62,143)
Pastoralist 7 4255 167(64,269)
![Page 27: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/27.jpg)
Prevalence of Smear positive and bactiriologically confirmed TB by age group
among participants
Age P of S+ per 100000(95%CI)
P of S+ and/or C+ per 100000(95%CI)
15‐24 101 (46–157) 266 (178–354)25‐34 81 (28–134) 218 (129–307)35‐44 111 (41–181) 237 (122–353)45‐54 136 (22–249) 321 (152–490)55‐64 158 (19–297) 369 (146–592)65+ 39 (0–118) 215 (22–408)
![Page 28: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/28.jpg)
Survey detected cases
0
5
10
15
20
25
30
35
40
-24 -34 -44 -54 -64 65-
C+ S+
55% (60/110) are younger than 35
![Page 29: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/29.jpg)
Smear + < Smear negative culture positive
0
5
10
15
20
25
-24 -34 -44 -54 -64 65-
S+ C+
42.7% of Confirmed cases are smear positive
![Page 30: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/30.jpg)
Survey detected cases and case notification in 2010
0
2
4
6
8
10
12
14
16
18
‐24 ‐34 ‐44 ‐54 ‐64 65‐
Female
Male
Smear Positive Cases Detected
Survey Notification data 2010
![Page 31: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/31.jpg)
TB history of Prevalent Cases98% of C+ (94/96) are undetected cases
• 33 S+C+32 Not on treatment (97%)– 27 New Cases (No TB Treatment
History at least in 5 years)– 5 Previously Treated– 1 On treatment
• 14 S+C‐13 Not on treatment (93%)– 10 New– 3 Previously treated– 1 Previously treated and On
treatment
• 63 S‐C+62 Not on treatment
(99%) – 59 New – 3 Previously treated– 1 Previously treated and On
treatment
![Page 32: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/32.jpg)
Extrapolating nationwide prevalence
• Adjusting for children (0‐14)– Percentage of children over total population is 45%– S+ notification rate per 100,000 of children since 2000 has: mean=7.5
SD=1.1– Assuming notification is a correct estimate of prevalence rate– Prevalence among total population
ptotal=pchild*c + padult*(1‐c) where pchild is the prevalence among children, padult the prevalence among adults drawn from the survey and c the percentage of children in the country
• Adjusting for extra‐pulmonary TB– Assuming EP prevalence rate constant across all ages– Percentage of EP over total notifications since 2000 has: mean=34.8%
SD=1.2%
![Page 33: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/33.jpg)
Prevalence of TB in Ethiopia (extrapolation using survey result and
program routine report)
Forms of TB
P per 100000
95%CI Notification rate of the country for/100000
WHO estimate,
Smear positive TB
61 44‐81 57 284(2008estimate)
Bacteriologicallyconfirmed TB
146 118‐176
All forms of TB
224 181‐271
183 585(2010report)
![Page 34: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/34.jpg)
5. Strengths/Limitations• Strong commitment and leadership of government• Committed survey team• Open process: contribution to other African countries
• Good community involvement and their contributions
• High participation rate• High sputum collection rate• International standard screening practice• Strong supports by partners especially by WHO CO and HQ
• Country – country collaboration
![Page 35: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/35.jpg)
Strength….
• Using the national TB laboratory for both smear and culture examination
• Strict supervision of lab by senior microbiologists
![Page 36: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/36.jpg)
Limitations‐ Age <15 not studied ‐ Only one culture per "suspect"
![Page 37: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/37.jpg)
6. Major Findings• Observed TB prevalence is much lower than WHO estimation
• Most patients (55 %) were young (15 to 34)• Male: Female ratio is almost 1:1• Smear Positive Cases account only 43% of bacteriologically positive cases
![Page 38: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/38.jpg)
7. Implication to the Program
• Incidence rate of smear positive TB could be <70/100000? (WHO estimate 163/100000)
• Ethiopia could achieve MDG targets for TB• From 47 smear positive TB cases only two were on treatment and 27 individuals were symptomatic: this is an indication that TB is circulating in the community and there is a need to strengthen TB screening in the community.
![Page 39: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/39.jpg)
Implication to the Program...
• The survey result shows x‐ray picks up most bacteriologically confirmed TB cases.– Chest x‐ray could be a good tool to screen or diagnose pulmonary TB
• More than 50 % of cases are smear negative and culture positives
![Page 40: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/40.jpg)
Acknowledgement
• WHO (HQ, CO)• Italian cooperation• TBCARE, Ethiopia• USAID• GLRA
![Page 41: TB survey 2011 Preliminary Resultaarc.gov.et › images › demo1 › Ethiopia collection › lille_oct11... · 2016-12-02 · 1. Introduction Oromiya Somali Amhara Afar SNNPR Tigray](https://reader033.vdocument.in/reader033/viewer/2022053017/5f1ac1c9a087c30f1051d4a6/html5/thumbnails/41.jpg)