However, tb diagnosis in ethiopia has been mainly based on sputum smear microscopy. Ethiopia could be a model country for tuberculosis control. Mdr rr tb cases started on secondline treatment in 2016 72% 703 xdr tb cases started on secondline treatment in 2016 tb. Multidrugresistant tuberculosis mdr tb has continued to be a challenge for tuberculosis tb control globally. Determinants of multidrugresistant tuberculosis in addis. Multidrug resistant mdr tb in ethiopia may be more prevalent than previously appreciated. In summary, this thesis provided settingspecific information about the epidemiology of mdr tb in ethiopia and china, and estimated the psychosocial burden of mdr tb. 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. Low prevalence of mycobacterium bovis in tuberculosis. Risk factors for multidrug resistant tuberculosis patients. This study determined the prevalence of mdr tb among presumptive mdr cases referred to a tb referral laboratory in the tigray region of ethiopia. Epidemiology of multidrugresistant tuberculosis mdrtb. Ethiopia is also one of the 27 high mdr tb burden countries. Conclusions the burden of mdrtb remains high in ethiopian settings, especially in previously treated tb cases.
Ethiopia is 15th among the 27 mdrtb highburden countries. Ethiopia is the third largest and populous country in africa. Determinants of multidrugresistant tuberculosis in patients who. The programmatic management of multidrugresistant tuberculosis mdr tb is entirely based on a who recommended longterm, 1824 month lasting treatment regimen. Multidrugresistant tuberculosis mdrtb has continued to be a challenge for tuberculosis tb control globally. Multidrugresistant tuberculosis mdr tb is resistant to the two main firstline anti tuberculosis drugs. Multidrug resistant tuberculosis mdr tb is becoming a major challenge of the tuberculosis tb control program in ethiopia. Multidrugresistant tuberculosis mdr tb in hiv endemic settings is a major threat to public health. Pdf prevalence of multidrugresistant tuberculosis and. Kncv is the lead partner in challenge tb, the usaidfunded 5year global program to decrease tb mortality and morbidity in high burdened countries.
Ethiopia is one of the high multidrugresistant tuberculosis mdr tb burden countries. Pdf the emergence of drugresistant tuberculosis tb, particularly multidrug resistant mdr and extensively drugresistant xdr tb. In this study, we used the 2016 global burden of diseases, injuries and risk factors gbd data to analyze the incidence, prevalence and mortality rates of tuberculosis tb in ethiopia over the last 26 years. Ethiopia tuberculosis profile world health organization. Despite considerable achievements in tackling tb over the last decade, ethiopia continues to have a high burden of tb and multidrugresistant tb mdr tb. Pdf determinants of multidrugresistant tuberculosis in. Multidrug resistant tuberculosismdrtb is becoming a major threat to tuberculosis control programs in. The report provides a comprehensive and uptodate assessment of the tb epidemic, and progress in the response, at global, regional and country levels.
Multidrugresistant tuberculosis in ethiopian settings and. The main purpose of this study was to determine the prevalence of mdr tb and associated factors in ethiopia. Risk factors for multidrug resistant tuberculosis patients in amhara. Estimated mdr tb cases among new pulmonary tb cases notified in 2009 1 500 8702 600 estimated mdr tb cases among retreated pulmonary tb cases notified in 2009 420 230740 mdr tb reported cases 2009 new retreatment total cases tested for mdr tb 16 298 377 % of notified tested for mdr tb mdr tb 12 180 233 mdr. Our findings indicate that the proportion of pulmonary tuberculosis due to m. Generating epidemiological data on multidrugresistant tuberculosis mdr tb is essential to assess the magnitude and trends of anti tb drug resistance. Pdf risk factors for multidrug resistant tuberculosis. Ethiopia tuberculosis profile population 2018 109 million estimates of tb burden. Treatment success rates for mdr tb are a remarkable 78% worldwide, the rate is 48%. Tuberculosis prevalence ethiopian public health institute. It features data on disease trends and the response to the epidemic in 202 countries and territories. However, data on mdr tb in ethiopia in general, and in our study area in particular, are very scarce.
Kncv tuberculosis foundation is looking for a fulltime. 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. Ethiopia is among the 30 high tb, hiv and mdr tb burden countries, with annual estimated tb incidence of 177100,000 populations and death rate of 25 per 100,000 populations for 2016. Pdf multidrug resistant tuberculosis in ethiopian settings and its. Spatial frailty survival model for multidrugresistant. About 9% of mdr tb cases also have resistance to two other classes of drugs, or extensively drugresistant tb xdr tb. Mdr xdr tb colour test for drug susceptibility testing of mycobacterium tuberculosis, northwest ethiopia. Moreover, ethiopia is also one of the 27 countries with a high burden of multidrugresistant tuberculosis mdr tb. Our resources improve and expand tb diagnostic and treatment services and screening in rural areas and among. Current treatment of multidrug resistant tuberculosis in. To determine the drug susceptibility pattern of mycobacterium tuberculosis isolates and to genetically characterise multidrugresistant tuberculosis mdr tb isolates.
Risk factors for multidrug resistant tuberculosis patients in amhara national regional state. Roughly 90% of patients with drugsensitive tuberculosis were successfully treated. The aim of this study was to examine spatial variation of mortality and the risk factor of death on multidrugresistant tuberculosis patients treated in different mdr tb hospitals of. Ethiopia is one of the countries with high mdr tb burden. Pdf the emergence of drugresistant tuberculosis tb, particularly multidrugresistant mdr and extensively drugresistant xdr tb. New ethiopian tb guildline november 2016 slideshare. Tb hiv and mdr tb burden countries with an estimated tb incidence of 164 per 100,000 population of drug susceptible tb. However, growing evidence shows that low treatment success rate and high rates of adverse events are associated with this regimen.
By march 20, 84 countries had reported at least one xdr tb case. Improving tb detection rates and further reducing the burden of disease in ethiopia will require optimization of. Federal democratic republic of ethiopia ministry of health. Review open access multidrugresistant tuberculosis in. Mdrtb clinicianinternist addis ababa, ethiopia kncv. Risk factors for the occurrence of multidrugresistant. Ethiopia, tb treatment gaps remain especially among mdrtb cases 12. Ambulatory care for multidrugresistant tuberculosis. More than half of presumptive multidrugresistant cases. Identification of survival rate and risk factors of mortality in mdr tb cases is essential for proper planning and effective implementation of mdr tb treatment. An estimated 17% of all tuberculosis cases in ethiopia are caused by mycobacterium bovis. The burden of tuberculosis tb has not been comprehensively evaluated over the last 25 years in ethiopia. The objective of this study was to assess the potential risk factors for multidrugresistant tuberculosis among patients undergoing mdr tb treatment at two community hospitals in ethiopia.
In addition, the burden of mdr tb in ethiopia is increasing. 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. To investigate the opportunities and challenges faced by treatment followup health centres tfcs when managing mdr tb patients, with greater focus on recording, tb. Tuberculosis tb, a disease caused by mycobacterium tuberculosis mtb, is the main cause of death. Phenotypic and genotypic analysis of multidrugresistant. Prevalence of multidrugresistant tuberculosis and associated factors in ethiopia. However, there are limited evidence 4,12, on intermittent treatment interruption, and its effects on treatment outcome in patients with mdr tb. The diagnosis of mdr tb can take several months or even longer often too late for the patient. In 2015, the treatment success rate for multidrugresistant mdrtb cases in ethiopia was reported to be 68% who, 2016.
Since the treatment of mdr tb in ethiopia started recently, the survival rate and its determinant factors among patients under mdr tb treatment are not described. Ethiopia launched new guideline for reaching missed. According to the 2014 who global tb report, 22 high burden countries account for 80 percent of the global tb cases and ethiopia has the tenth highest tb burden in the world. Efforts to control the global burden of tuberculosis tb epidemic have now been jeopardized by the rapid evolution of drugresistant mycobacterium tuberculosis mtb, which are resistant to one or more anti tb drugs. The aim of this study was to describe the characteristics of patients with mdr.
Posted 30 oct 2017 originally published 30 oct 2017 origin view original. Mdr tb is a substantial and underreported problem in subsaharan africa ssa, with recognised cases projected to increase with advancement in diagnostic technology. Last year, ethiopia saw around 140 000 cases of tuberculosis, which probably amounts to twothirds of the total burden. Multidrug resistant tuberculosis in ethiopian settings and. Efforts to expand diagnostic services, treatment and care.
Multidrugresistant tuberculosis mdr tb has been jeopardizing the global effort to prevent and control tuberculosis tb. It disproportionally affects those living in the different regions of countries and within the region. National tuberculosis reference laboratory, addis ababa, ethiopia. Wondemagegn mulu1, daniel mekonnen1, mulat yimer1, aschalew admassu2, bayeh abera1 1. At the end of february 2012, a total of 424 cases of mdrtb. Current treatment of multidrug resistant tuberculosis in ethiopia. The new guideline on reaching missed tb cases in ethiopia utilized the generic guidance on prioritization developed by who and stop tb partnership. This study was aimed to assess predictor of mdr tb in southwest part of ethiopia. Ethiopia, the second most populous nation in africa with a population of 92 million, is among the 27 high mdr tb burdened countries identified by the who and has an estimated 2100 new mdr tb cases per year.
Also, in 2016 about 19% of previously treated tb cases were estimated to have either rifampicin or multi drug resistant tb. Likewise, two studies reported xdr tb in the range of 1% 4. Manual searching was also done from the institutional repository websites of ethiopian universities such as addis ababa university, and. Efforts to control the global burden of tuberculosis tb have been jeopardized by the rapid evolution of multidrug resistant mycobacterium tuberculosis mtb, which is resistant to at least isoniazid and rifampicin. Efforts by the national tb programme to control mdr tb include expanding ambulatory care. The objective of the study was to investigate risk factors for mdr tb. Prevalence of multidrugresistant tuberculosis and associated. Ethiopia is one of the 30 high mdr tb prevalent countries and the burden of mdr tb is increasing with an estimated incidence of 2. Comparison of the yield of tuberculosis among contacts of multidrug. Previous studies have documented variable prevalences of multidrugresistant tuberculosis mdr tb and its risk factors in ethiopia. Intermittent treatment interruption and its effect on. This includes trends in tb incidence and mortality, data on case detection and treatment results for tb, multidrugresistant tb mdr tb, tb. Untreated, mdr tb is a deadly disease affecting impoverished people who cannot afford timely diagnosis and adequate treatment for this curable illness.
This quantitative, descriptive study investigated risk factors for mdr tb in addis ababa, ethiopia. Pdf predictor of multidrug resistant tuberculosis in. Up to date, the mdr tb treatment outcome is not sufficiently understood in ethiopia. Global tuberculosis report 2019 world health organization. Mdr rr tb cases started on secondline treatment in 2016 72% 703 xdr tb cases started on secondline treatment in 2016 tb preventive treatment, 2018. However, there are limited evidence 4, 12, on intermittent treatment interruption, and its effects on treatment outcome in patients with mdr tb. Mdrxdrtb colour test for drug susceptibility testing of. Alert hospital in addis ababa is one of the 40 health centres in the country with the capacity to diagnose and treat mdr tb.
The most powerful predictor of the emergence of mdr tb reported in ethiopia is previous exposure to anti tb drug treatment. Department of medical microbiology, immunology and parasitology, college of medicine and health sciences, bahir dar university, ethiopia 2. Little information is available regarding the determinants of mdr tb in ethiopia, and hence, we assessed the probable determinants of mdr tb in southern ethiopia. Ethiopia is one of tb, tb hiv, and multidrug resistant tuberculosis mdr tb high burden country globally. Tuberculosis treatment outcomes in ethiopia from 2003 to. Treatment outcomes and antiretroviral uptake in multidrug. To determine risk factors of mdrtb patients in amhara national. Multidrugresistant tuberculosis mdr tb is an emerging public health problem in ethiopia. Based on these studies, a simple risk score was developed to estimate the absolute risk of poor treatment outcomes in patients with mdr tb.
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