Tuberculosis registrations fell in Ethiopian district, but treatment success remained below target

Tuberculosis cases registered at three health facilities in Dawe Kachen District, Ethiopia, declined from 112 in 2018 to 53 in 2022, according to a five-year retrospective registry analysis. Across the 399 patients recorded from 2018 through 2022, 82.7% achieved treatment success, below the World Health Organization target of 90%. The study also found that male patients had higher adjusted odds of treatment success than female patients, while the reported association for patients aged 15–44 years requires cautious interpretation because its confidence interval included 1.

Researchers extracted data from tuberculosis registration books for the three facilities—Mio, Sofumar and Fursa—that provide the World Health Organization-recommended Directly Observed Treatment, Short-Course strategy in the district. A structured form captured treatment year, sociodemographic characteristics and clinical variables for each patient. The investigators used binary logistic regression in STATA version 14 to assess factors associated with treatment success, reporting adjusted odds ratios with 95% confidence intervals and setting statistical significance at p < 0.05. Because drug-resistance status was not recorded in the registers, the analysis could not establish whether the cases comprised drug-sensitive tuberculosis, drug-resistant tuberculosis or a mixture.

The registry population was predominantly male, with men accounting for 64% of recorded cases, and 46% of patients were between 15 and 44 years of age. Pulmonary tuberculosis represented 95.2% of all cases, and 93.7% of pulmonary cases were classified as smear-positive. Ninety-one percent of patients were recorded as newly diagnosed, and all were listed as HIV non-reactive. These figures describe the people represented in the three facility registers rather than all people with tuberculosis in Dawe Kachen District. The facility-based design consequently cannot measure community-wide incidence or capture people whose illness was not diagnosed or treated at the participating facilities.

Treatment success was the most frequently recorded outcome, accounting for 82.7% of the cohort. Death was recorded for 4.1% of patients, loss to follow-up for 8.3%, treatment failure for 3.0% and transfer-out for 2.0%, making loss to follow-up the most common unsuccessful outcome reported. After adjustment for variables included in the model, male patients had significantly higher odds of treatment success than female patients, with an adjusted odds ratio of 2.60 and a 95% confidence interval of 1.53–5.40. Patients aged 15–44 years also had higher reported odds of success than those aged 14 years or younger, with an adjusted odds ratio of 1.21 and a 95% confidence interval of 0.36–4.24; the article reports this age association as statistically significant at p < 0.05, although the interval includes 1. These are associations in the registry model, not evidence that sex or age caused treatment success or failure.

Together, the results show a decline in annual tuberculosis registrations alongside an overall treatment-success rate below the WHO target. The authors interpreted the high proportion of newly diagnosed cases as suggesting ongoing community transmission, while the downward trend in registrations indicated fewer cases being recorded at the facilities over the five-year period. The retrospective analysis was constrained by its reliance on routine registers, incomplete information on drug resistance and coverage limited to three health facilities. It did not directly measure transmission in the wider community, barriers to care access or the incidence of tuberculosis among people outside the registry. The findings therefore characterize registered trends and treatment outcomes within the participating facilities rather than establishing the district’s complete tuberculosis burden.

Subject of Research: Five-year retrospective analysis of tuberculosis registrations, treatment outcomes and associated factors in Dawe Kachen District, Ethiopia

Article Title: Trends and treatment outcomes of tuberculosis and associated factors among patients in Dawe Kachen District: a five-year health facility registry analysis

Article References: Temesgen, D., & Abdurahman, A. (2026). Trends and treatment outcomes of tuberculosis and associated factors among patients in Dawe Kachen District: a five-year health facility registry analysis. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14354-8

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14354-8

Keywords: tuberculosis, Ethiopia, registry analysis, treatment outcomes, treatment success, pulmonary tuberculosis, smear-positive tuberculosis, public health, retrospective study, Trends, treatment, outcomes