BackgroundEthiopia is ranked number seven among the 22 high burden TB countries (1). The Ethiopian national guidelines for the combined management and technical handling of TB, TB/HIV and leprosy, is found in a standardized manual distributed by WHO (2). Our main objective was to assess the implementation of DOTS in Bahir Dar in means of following the national guidelines in the manual of 2008.
MethodsThe study was conducted as an operational research, where we looked at TB registrations in the time period 2008-2010 at three different health facilities in Bahir Dar town, retrospectively.
Results and discussionThe study includes a total of 3,343 TB patients. The amount of ss+PTB patients was low (totally 16.7%), while the numbers of EPTB patients was high (totally 45.9%). The treatment success rate in 2010 was overall 74.8%. At the hospital it was only 60%, contributed by a low registration of treatment outcome (almost 30%) and 10% deaths. In 2010, totally 82% of the TB patients were tested for HIV as recommended and 35% were found HIV positive; much more the national average of 15%.The TB registration was sometimes incomplete and inconsistent.
ConclusionsWe generally found that they did a good job, and that they were improving e.g. in offering the recommended HIV testing of TB patients. However, the global target for treatment success rate was not yet achieved, and the data quality showed possibilities for improvements. This might be done by further operational research, regular supportive supervision from the DHO and health workers training in DOTS.