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Prospects for tuberculosis elimination in Ethiopia : feasibility, challenges, and opportunities

Agizew, Tefera Belachew ; Dememew, Zewdu Gashu ; Leta, Taye ; Hiruy, Nebiyu ; Tesema, Emawayish ; Abelti, Eshetu Abdissa ; Gebreyohannes, Asfawesen ; Alemayehu, Yohannes Molla ; Omer, Ahmed Bedru and Suarez, Pedro Guillermo , et al. (2022) In The Pan African medical journal 43.
Abstract

To end the global tuberculosis (TB) epidemic and eliminate TB, countries around the world committed to significantly expanding the scope of their efforts, including rapid uptake of new tools, interventions, and strategies, and envisioned a world free of TB. Between 2010 and 2020, Ethiopia experienced a 5% average annual decline in TB incidence. However, at that current rate, ending the TB epidemic (<10 TB cases/100,000 population) may not be possible soon. As a high TB and TB/HIV burden country, Ethiopia's TB epidemic is characterized by a high rate of transmission in the general population and hard-to-reach areas and progression of latent TB infection (LTBI) rather than cross-border migration. Studies suggest that a combination of... (More)

To end the global tuberculosis (TB) epidemic and eliminate TB, countries around the world committed to significantly expanding the scope of their efforts, including rapid uptake of new tools, interventions, and strategies, and envisioned a world free of TB. Between 2010 and 2020, Ethiopia experienced a 5% average annual decline in TB incidence. However, at that current rate, ending the TB epidemic (<10 TB cases/100,000 population) may not be possible soon. As a high TB and TB/HIV burden country, Ethiopia's TB epidemic is characterized by a high rate of transmission in the general population and hard-to-reach areas and progression of latent TB infection (LTBI) rather than cross-border migration. Studies suggest that a combination of interventions, such as intensive household screening with TB preventive therapy, has the potential to significantly decrease the incidence of TB. The feasibility of reducing the population-level TB incidence by a combination of interventions in Ethiopia is unknown. Based on the World Health Organization's TB elimination framework and the END TB strategic documents and previously published reviews in TB elimination we conducted a narrative review to summarize and estimated the effect of a combined intervention package (community-based TB screening for active case finding and TB and LTBI prevention and treatment among high-risk groups like household and close contacts). The projected annual decline of TB incidence was above 16%. With this level of impact and nationwide scale-up of the interventions, Ethiopia aligns well with ending the TB epidemic before 2035 and shifting toward TB elimination in the foreseeable future. In the Ethiopia setting, we recommend future studies generating evidence on the impact of the combination intervention package to reduce TB incidence in Ethiopia, which is aiming to shift from control to TB elimination.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Ethiopia/epidemiology, Feasibility Studies, Latent Tuberculosis/epidemiology, Global Health, Incidence, Tuberculosis, Miliary
in
The Pan African medical journal
volume
43
article number
146
publisher
African Field Epidemiology Network
external identifiers
  • scopus:85146479031
  • pmid:36785687
ISSN
1937-8688
DOI
10.11604/pamj.2022.43.146.35557
language
English
LU publication?
no
additional info
Copyright: Tefera Belachew Agizew et al.
id
0b7b7ae7-97b1-4add-9647-4adcd1eb6bdb
date added to LUP
2023-04-26 13:16:00
date last changed
2024-04-19 21:04:16
@article{0b7b7ae7-97b1-4add-9647-4adcd1eb6bdb,
  abstract     = {{<p>To end the global tuberculosis (TB) epidemic and eliminate TB, countries around the world committed to significantly expanding the scope of their efforts, including rapid uptake of new tools, interventions, and strategies, and envisioned a world free of TB. Between 2010 and 2020, Ethiopia experienced a 5% average annual decline in TB incidence. However, at that current rate, ending the TB epidemic (&lt;10 TB cases/100,000 population) may not be possible soon. As a high TB and TB/HIV burden country, Ethiopia's TB epidemic is characterized by a high rate of transmission in the general population and hard-to-reach areas and progression of latent TB infection (LTBI) rather than cross-border migration. Studies suggest that a combination of interventions, such as intensive household screening with TB preventive therapy, has the potential to significantly decrease the incidence of TB. The feasibility of reducing the population-level TB incidence by a combination of interventions in Ethiopia is unknown. Based on the World Health Organization's TB elimination framework and the END TB strategic documents and previously published reviews in TB elimination we conducted a narrative review to summarize and estimated the effect of a combined intervention package (community-based TB screening for active case finding and TB and LTBI prevention and treatment among high-risk groups like household and close contacts). The projected annual decline of TB incidence was above 16%. With this level of impact and nationwide scale-up of the interventions, Ethiopia aligns well with ending the TB epidemic before 2035 and shifting toward TB elimination in the foreseeable future. In the Ethiopia setting, we recommend future studies generating evidence on the impact of the combination intervention package to reduce TB incidence in Ethiopia, which is aiming to shift from control to TB elimination.</p>}},
  author       = {{Agizew, Tefera Belachew and Dememew, Zewdu Gashu and Leta, Taye and Hiruy, Nebiyu and Tesema, Emawayish and Abelti, Eshetu Abdissa and Gebreyohannes, Asfawesen and Alemayehu, Yohannes Molla and Omer, Ahmed Bedru and Suarez, Pedro Guillermo and Kassie, Yewulsew and Kassa, Anteneh and Gemechu, Daniel and Jerene, Degu}},
  issn         = {{1937-8688}},
  keywords     = {{Humans; Ethiopia/epidemiology; Feasibility Studies; Latent Tuberculosis/epidemiology; Global Health; Incidence; Tuberculosis, Miliary}},
  language     = {{eng}},
  publisher    = {{African Field Epidemiology Network}},
  series       = {{The Pan African medical journal}},
  title        = {{Prospects for tuberculosis elimination in Ethiopia : feasibility, challenges, and opportunities}},
  url          = {{http://dx.doi.org/10.11604/pamj.2022.43.146.35557}},
  doi          = {{10.11604/pamj.2022.43.146.35557}},
  volume       = {{43}},
  year         = {{2022}},
}