ArticleBMJ global health2017
Health extension workers improve tuberculosis case finding and treatment outcome in Ethiopia: a large-scale implementation study.
Article in BMJ global health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Community-based active case-finding interventions for tuberculosis: a systematic review.The Lancet. Public health · 2021Pooled it
- Pooled it
- Effect of integrating traditional and modern healthcare systems on tuberculosis case detection in Ethiopia: a cluster randomized controlled study.Infectious diseases of poverty · 2025Trial
- Knowledge, attitudes, and perceived barriers to tuberculosis care among patients and household contacts in Wolisso District, Oromia Region, Ethiopia.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Article
- Assessing the gender responsiveness of tuberculosis interventions: a scoping review (2000-2025).Systematic reviews · 2026Article
- Determinants of tuberculosis presentation and successful treatment outcome among tuberculosis patients in Geita, Tanzania.PloS one · 2026Article
- Quantifying undetected tuberculosis in Ethiopia using a novel geospatial modelling approach.Scientific reports · 2025Article
- Capacity-building interventions for health extension workers in Ethiopia: A scoping review.PloS one · 2025Article
- Building community networks and engagement for effective TB case management.Frontiers in public health · 2025Review
- Multidimensional performance enablers of Ethiopian community-based health extension program: A scoping review.PloS one · 2025Article
- Article
- Interventions and implementation considerations for reducing pre-treatment loss to follow-up in adults with pulmonary tuberculosis: A scoping review.F1000Research · 2024Article
- Communicable and Non-communicable Diseases Diagnosis and Treatment Service Availability at Primary Health Care Units During COVID-19 Outbreak in Ethiopia.Ethiopian journal of health sciences · 2023Article
- Spatiotemporal Distribution of Tuberculosis in the Oromia Region of Ethiopia: A Hotspot Analysis.Tropical medicine and infectious disease · 2023Article
- Article
- Economic evaluation of a community health worker model for tuberculosis care in Ho Chi Minh City, Viet Nam: a mixed-methods Social Return on Investment Analysis.BMC public health · 2023Article
- Total delay and associated factors among tuberculosis patients in Jimma Zone, Southwest Ethiopia.PloS one · 2023Article
- Knowledge, Attitudes, and Perceptions of Tuberculosis in Indonesia: A Multi-Center Cross-Sectional Study.Infection and drug resistance · 2023Article
- Integrating private health facilities in government-led health systems: a case study of the public-private mix approach in Ethiopia.BMC health services research · 2022Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculosis (TB) is a major cause of death in Ethiopia. One of the main barriers for TB control is the lack of access to health services.
methodsWe evaluated a diagnostic and treatment service for TB based on the health extension workers (HEW) of the Ethiopian Health Extension Programme in Sidama Zone, with 3.5 million population. We added the services to the HEW routines and evaluated their effect over 4.5 years. 1024 HEWs were trained to identify individuals with symptoms of TB, request sputum samples and prepare smears. Smears were transported to designated laboratories. Individuals with TB were offered treatment at home or the local health post. A second zone (Hadiya) with 1.2 million population was selected as control. We compared TB case notification rates (CNR) and treatment outcomes in the zones 3 years before and 4.5 years after intervention.
resultsHEWs identified 216 165 individuals with symptoms and 27 918 (12%) were diagnosed with TB. Smear-positive TB CNR increased from 64 (95% CI 62.5 to 65.8) to 127 (95% CI 123.8 to 131.2) and all forms of TB increased from 102 (95% CI 99.1 to 105.8) to 177 (95% CI 172.6 to 181.0) per 100 000 population in the first year of intervention. In subsequent years, the smear-positive CNR declined by 9% per year. There was no change in CNR in the control area. Treatment success increased from 76% before the intervention to 95% during the intervention. Patients lost to follow-up decreased from 21% to 3% (p<0.001).
conclusionA community-based package significantly increased case finding and improved treatment outcome. Implementing this strategy could help meet the Ethiopian Sustainable Development Goal targets.
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