Ketema KH, Raya J, Workineh T, Klinkenberg E, Enquselassie F. Does decentralisation of tuberculosis care influence treatment outcomes? The case of Oromia Region, Ethiopia.
Public Health Action 2015;
4:S13-7. [PMID:
26478507 DOI:
10.5588/pha.14.0059]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/25/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING
Oromia Region, Ethiopia.
OBJECTIVE
To investigate the effect of decentralised care on anti-tuberculosis treatment outcomes and identify factors affecting outcome among new smear-positive tuberculosis (TB) patients.
DESIGN
This was a retrospective cohort study comparing patients treated in the community during the continuation phase with those managed throughout treatment in health facilities. Data were collected from TB registers and patient cards using a pre-tested data capture form.
RESULTS
Of the 2226 new smear-positive TB patients registered from July 2010 to June 2012 who were included in the study, 1599 (72.6%) received treatment in health facilities, and the rest in the community. Overall treatment success was 94.7%. Patients treated in the community had comparable treatment success with those managed in health facilities (aOR 1.7, 95%CI 0.80-3.57). Missing doses (OR 0.22, 95%CI 0.08-0.55), supervision during the continuation phase (OR 2.6, 95%CI 1.34-5.05), positive sputum at month 2 (OR 0.07, 95%CI 0.04-0.13) and human immunodeficiency virus infection (OR 0.25, 95%CI 0.13-0.46) were independent predictors of treatment success.
CONCLUSION
Overall treatment success is high in new smear-positive TB patients in Oromia. Patients receiving treatment in the community during the continuation phase have treatment success comparable with that of patients managed in health facilities.
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