Abstract
Aim
The aim of this work was to study the incidence of tuberculosis (TB) in El-Behira Governorate before and after application of DOTS (direct observed therapy short course strategy) to evaluate the National Tuberculosis Control Program in El-Behira Governorate as a representative part of Egypt.
Patients and methods
This work was a retrospective, descriptive, analytical study of the TB situation before and after DOTS, carried out at Chest Hospital, El-Behira Governorate, Egypt, and related dispensaries. All available data on registered TB cases from January 1996 until December 2010 (15-year duration) were collected, including demographic data, diagnosis of disease, sputum smear results, previous treatment history, and treatment outcome. A descriptive analysis of the data was performed using the SPSS statistical program. Data were described in absolute numbers and percentages. Statistical significance was set at P values less than 0.05.
Results
The incidence of TB (n = 10 035) was higher in age groups 15–29 and 30–45 years [n = 3829 (38.2%) and n = 2827 (28.1%), respectively], and in male patients [n = 6511 (64.8%)] compared with female patients [n = 3524 (35.2%)]. Pulmonary cases (78.8%) were more than extrapulmonary cases (21.2%). There was improvement in cure rate, treatment completion rate, treatment success rate, number of retreatment cases, and default rate after DOTS application (46–61.1, 16.1–18.6, 62.1–79.7, 29.1–12.4, and 20.4–6.8%, respectively).
Conclusion
TB is a burden of the productive age group of 15–45 years, with a higher incidence in men than in women, and DOTS is an effective tool for controlling TB in El-Behira Governorate. The implementation of this tool has led to significant increase in treatment success and decrease in default and failure rates.
Article PDF
Similar content being viewed by others
References
WHO. Tuberculosis, WHO fact sheet no. 104; 2014. Available at: http://www.who.int/mediacentre/factsheets/fs104/en/. [Last accessed on 2014 Oct].
WHO. Treatment of tuberculosis guidelines for National Tuberculosis Programmes. 3rd ed. Geneva: WHO; 2003. 313.
Knapp RG, Miller MC. Clinical Epidemiology and Biostatistics. Baltimore, Md, USA: Harwal; 1992.
Hindi MR. Assessment of directly observed therapy short course (DOTS) of tuberculosis in Benha Chest Hospital MSc thesis]. Egypt: Benha University; 2009.
Abdel-Rahman M. Study of the pattern of variable forms of tuberculosis in Fayoum Chest Hospital in the period from June 2006 — June 2009 MSc thesis]. Cairo: Ain Shams University; 2010.
Abdelghany A. Tuberculosis situation in Menoufia governorate (1992–2008) before and after Direct Observed Therapy Short Course Strategy (DOTS) MSc thesis]. Benha: Benha Faculty of Medicine, 2010.
George MM. Tuberculosis situation in El-Minia governorate (1997–2010) before and after Direct Observed Therapy Short Course Strategy (DOTS) MSc thesis]. Benha: Benha University; 2013.
Zeheiry SH. Assessment of directly observed therapy short course (DOTS) of tuberculosis in Dakahlia governorate Chest hospitals from 2006 to 2011 MSc thesis]. Benha: Benha University; 2012.
Al-Aarag AH. Morbidity and mortality from pulmonary tuberculosis in Benha region MSc thesis]. Benha: Benha Faculty of Medicine, Zagazig University; 1983.
Chengsorn N, Bloss E, Anekvorapong R, Anuwatnonthakate A, Wattanaamornkiat W, Komsakorn S, et al. Tuberculosis services and treatment outcomes in private and public health care facilities in Thailand, 2004–2006. Int J Tuberc Lung Dis 2009; 13:888–894.
Bello SI, Itiola OA. Drug adherence amongst tuberculosis patients in the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Afr J Pharm Pharmacol 2010; 4:109–114.
Sudre P, Ten Dam G, Kochi A. Tuberculosis: a global overview of the situation today. Bull World Health Organ 1992; 70:149–159.
Shargie EB, Lindtjørn B. DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: a retrospective trend analysis. BMC Public Health 2005; 5:62.
Hossam AA. Evaluation of primary antituberculous drug resistance in new tuberculous patients with diabetes mellitus MSc thesis]. Cairo: Cairo University; 1999.
Fouad S. Primary drug resistance in newly diagnosed cases of pulmonary tuberculosis MSc thesis]. Cairo: Cairo University; 2003.
Floyd K, Hutubessy R, Samyshkin Y, Korobitsyn A, Fedorin I, Volchenkov G, et al. Health-systems efficiency in the Russian Federation: tuberculosis control. Bull World Health Organ 2006; 84:43–51.
Balasubramanian R, Garg R, Santha T, Gopi PG, Subramani R, Chandrasekaran V, et al. Gender disparities in tuberculosis. Report from a rural DOTS program in South India. Int J Tuberc Lung Dis 2004; 8:323–332.
Wondimu T, Michael KW, Kassahun W, Getachew S. Delay in initiating tuberculosis treatment and factors associated among pulmonary tuberculosis patients in East Wollega, Western Ethiopia. Ethiop J Heal Dev 2007; 21:148–156.
Frieden T. Toman’s tuberculosis, case detection, treatment, and monitoring — questions and answers. 2nd ed. Geneva: World Health Organization; 2004.
Anuwatnonthakate A, Limsomboon P, Nateniyom S, Wattanaamornkiat W, Komsakorn S, Moolphate S, et al. Directly observed therapy and improved tuberculosis treatment outcomes in Thailand. PLoS One 2008; 3:e3089.
Van Burg JL, Verver S, Borgdorff MW. The epidemiology of tuberculosis among asylum seekers in the Netherlands: implications for screening. Int J Tuberc Lung Dis 2003; 7:139–144.
Lowieke AM, Beek MJ, Vander W, et al. Extrapulmonary tuberculosis in the Netherlands, 1993–2001. Emerg Infect Dis 2006; 12:1080–6059.
Musellim B, Erturan S, Sonmez Duman E, Ongen G. Comparison of extra-pulmonary and pulmonary tuberculosis cases: factors influencing the site of reactivation. Int J Tuberc Lung Dis 2005; 9:1220–1123.
Mohan A, Nassir H, Niazi A. Does routine home visiting improve the return rate and outcome of DOTS patients who delay treatment? East Mediterr Health J 2003; 9:702–708.
Abassi A, Mansourian AR. Efficacy of DOTS strategy in treatment of respiratory tuberculosis in Gorgan, Islamic Republic of Iran. East Mediterr Health J 2007; 13:664–649.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Alwani, A.K., Al-Aarag, A.H., Omar, M.M. et al. Incidence of tuberculosis before and after DOTS (direct observed therapy short course strategy) implementation in El-Behira Governorate, Egypt. Egypt J Bronchol 9, 101–108 (2015). https://doi.org/10.4103/1687-8426.153665
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/1687-8426.153665