Trends of XXXX case notification and treatment outcomes in the sidama zone, southern ethiopia: ten-year retrospective trend analysis in urban-rural settings.

@entity1 @entity378 @entity1802 @entity1907
BACKGROUND: Ethiopia is one of the high @entity378 ( @entity378 ) burden countries. An analysis of trends and differentials in case notifications and treatment outcomes of @entity378 may help improve our understanding of the performance of @entity378 control services. METHODS: A retrospective trend analysis of @entity378 cases was conducted in the Sidama Zone in southern Ethiopia. We registered all @entity378 cases diagnosed and treated during 2003-2012 from all health facilities in the Sidama Zone, and analysed trends of @entity378 case notification rates and treatment outcomes. RESULTS: The smear positive ( @entity1802 +) case notification rate (CNR) increased from 55 (95% CI 52.5-58.4) to 111 (95% CI 107.4-114.4) per 105 @entity1 . The CNRs of @entity1802 + in @entity1 older than 45 years increased by fourfold, while the mortality of cases during treatment declined from 11% to 3% for smear negative ( @entity1802 -) (X2trend, P<0.001) and from 5% to 2% for @entity1802 + (X2trend, P<0.001). The treatment success was higher in rural areas (AOR 1.11; CI 95%: 1.03-1.2), less for @entity1802 - (AOR 0.86; CI 95%: 0.80-0.92) and higher for @entity1907 (AOR 1.10; CI 95%: 1.02-1.19) compared to @entity1802 +. A higher lost-to-follow up was observed in @entity1 (AOR 1.15; CI 95%: 1.06-1.24) and among @entity1802 - cases (AOR 1.14; CI 95%: 1.03-1.25). More deaths occurred in @entity1802 -cases (AOR 1.65; 95% CI: 1.44-1.90) and among cases older than 65 years (AOR 3.86; CI 95%: 2.94-5.10). Lastly, retreatment cases had a higher mortality than new cases (6% vs 3%). CONCLUSION: Over the past decade @entity378 CNRs and treatment outcomes improved, whereas the disparities of disease burden by gender and place of residence reduced and mortality declined. Strategies should be devised to address higher risk groups for poor treatment outcomes.
