Drug-susceptible tuberculosis treatment success and associated factors in Ethiopia from 2005 to 2017: a systematic review and meta-analysis

ObjectivesThe main aim of this study was to assess the overall tuberculosis (TB) treatment success in Ethiopia and to identify potential factors for poor TB treatment outcome.DesignA systematic review and meta-analysis of published literature was conducted. Original studies were identified through a...

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Published in:BMJ open Vol. 8; no. 9; p. e022111
Main Authors: Seid, Mohammed Assen, Ayalew, Mohammed Biset, Muche, Esileman Abdela, Gebreyohannes, Eyob Alemayehu, Abegaz, Tadesse Melaku
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 25.09.2018
BMJ Publishing Group
Subjects:
Acquired immune deficiency syndrome
AIDS
Clinical outcomes
Drug resistance
HIV
Human immunodeficiency virus
Infectious Diseases
Leprosy
Meta-analysis
Mortality
Patients
Success
Systematic review
Tuberculosis
United States > US
Ethiopia
meta-analysis
tuberclosis
drug-susceptible
ethiopia
systematic review
treatment outcome
ISSN:2044-6055, 2044-6055
Online Access:Get full text
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Summary:ObjectivesThe main aim of this study was to assess the overall tuberculosis (TB) treatment success in Ethiopia and to identify potential factors for poor TB treatment outcome.DesignA systematic review and meta-analysis of published literature was conducted. Original studies were identified through a computerised systematic search using PubMed, Google Scholar and Science Direct databases. Heterogeneity across studies was assessed using Cochran’s Q test and I2 statistic. Pooled estimates of treatment success were computed using the random-effects model with 95% CI using Stata V.14 software.ResultsA total of 230 articles were identified in the systematic search. Of these 34 observational studies were eligible for systematic review and meta-analysis. It was found that 117 750 patients reported treatment outcomes. Treatment outcomes were assessed by World Health Organization (WHO) standard definitions of TB treatment outcome. The overall pooled TB treatment success rate in Ethiopia was 86% (with 95% CI 83%_88%). TB treatment success rate for each region showed that, Addis Ababa (93%), Oromia (84%), Amhara (86%), Southern Nations (83%), Tigray (85%) and Afar (86%). Mainly old age, HIV co-infection, retreatment cases and rural residence were the most frequently identified factors associated with poor TB treatment outcome.ConclusionThe result of this study revealed that the overall TB treatment success rate in Ethiopia was below the threshold suggested by WHO (90%). There was also a discrepancy in TB treatment success rate among different regions of Ethiopia. In addition to these, HIV co-infection, older age, retreatment cases and rural residence were associated with poor treatment outcome. In order to further improve the treatment success rate, it is strategic to give special consideration for regions which had low TB treatment success and patients with TB with HIV co-infection, older age, rural residence and retreatment cases.
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-022111