Evidence map›Paper›PMID 39186714›Full record

ArticlePloS one2024

Drug-resistant tuberculosis care and treatment outcomes over the last 15 years in Ethiopia: Results from a mixed-method review of trends.

E Tesema, M Biru, T Leta, A Kumsa, A Liaulseged, G Gizatie, T Bogale, M Million, D G Datiko, A Gebreyohannes and 6 more

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. A QuantiFERONInfection and drug resistance · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

E TesemaUSAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia.ORCID 0000-0002-6775-4208
M BiruUSAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia.
T LetaMinistry of Health, National TB, Leprosy and other Lung Disease Program, Addis Ababa, Ethiopia.
A KumsaMinistry of Health, National TB, Leprosy and other Lung Disease Program, Addis Ababa, Ethiopia.
A LiaulsegedMinistry of Health, National TB, Leprosy and other Lung Disease Program, Addis Ababa, Ethiopia.
G GizatieUSAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia.
T BogaleUSAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia.
M MillionUSAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia.
D G DatikoUSAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia.
A GebreyohannesUSAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia.
Y MollaUSAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia.
N HiruyUSAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia.
M MebngaKNCV Tuberculosis Foundation, Moscow, Russia.
P G SuarezManagement Sciences for Health, Arlington, VA, United States of America.
Z G DememewUSAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia.
D JereneKNCV Tuberculosis Foundation, The Hague, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesDrug resistant tuberculosis (DR-TB) remains a global challenge with about a third of the cases are not detected. With the recent advances in the diagnosis and treatment follow-up of DR-TB, there have been improvements with treatment success rates. However, there is limited evidence on the successful models of care that have consistently registered good outcomes. Our aim was to assess Ethiopia's experience in scaling up an ambulatory, decentralized model of care while managing multiple regimen transition processes and external shocks.

methodsThis was a cross-sectional, mixed-method study. For the quantitative data, we reviewed routine surveillance data for the period 2009-2022 and collected additional data from publicly available reports. We then analyzed the data descriptively. Qualitative data were collected from program reports, quarterly presentations, minutes of technical working group meetings, and clinical review committee reports and analyzed thematically.

resultsThe number of DR-TB treatment initiating centers increased from 1 to 67, and enrollment increased from 88 in 2010 to 741 in 2019, but declined to 518 in 2022. A treatment success rate (TSR) of over 70% was sustained. The decentralized and ambulatory service delivery remained the core service delivery model. The country successfully navigated multiple regimen transitions, including the recently introduced six-month short oral regimen. Several challenges remain, including the lack of strong and sustainable specimen transportation system, lack of established systems for timely tracing and linking of missed DR-TB cases, and data quality issues.

conclusionsEthiopia scaled up a decentralized ambulatory model of care, kept up to date with recent developments in treatment regimens, and maintained a high TSR, despite the influence of multiple external challenges. The recent decline in case notification requires a deeper look into the underlying reasons. The feasibility of fully integrating DR-TB treatment and follow up at community level should be explored further.

Indexed as

Antitubercular AgentsTuberculosis, Multidrug-ResistantCross-Sectional StudiesEthiopiaHumansTreatment OutcomeAntitubercular Agents

Identifiers

PMID39186714
PMCPMC11346926

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.