Prevalence and incidence of symptomatic pulmonary tuberculosis based on repeated population screening in a district in Ethiopia: a prospective cohort study.

Objective: In Ethiopia, one-third of the estimated tuberculosis cases are not detected or reported. Incidence estimates are inaccurate and rarely measured directly. Assessing the 'real' incidence under programme conditions is useful to understand the situation.

Effect of multicomponent interventions on tuberculosis notification in mining and pastoralist districts of Oromia region in Ethiopia: a longitudinal quasi-experimental study.

Objective: To demonstrate the impact of interventions on tuberculosis (TB) case detection in mining and pastoralist districts in southeastern Ethiopia over a 10-year period.

Design: Longitudinal quasi-experimental study.

Setting: Health centres and hospitals in six mining districts implemented interventions and seven nearby districts functioned as controls.

How many of persistent coughers have pulmonary tuberculosis? Population-based cohort study in Ethiopia.

Objective: Many individuals with persistent cough and smear microscopy-negative sputum test for tuberculosis (TB) remain at risk of developing the disease. This study estimates the incidence of pulmonary TB (PTB) among initially smear-negative persistent coughers and its risk factors.

Design: A prospective population-based follow-up study.

Molecular Epidemiology of Mycobacterium tuberculosis strains isolated from pulmonary tuberculosis patients in south Ethiopia.

Introduction: Understanding the epidemiology of tuberculosis is limited by lack of genotyping data. We sought to characterize the drug susceptibility testing patterns and genetic diversity of M. tuberculosis isolates in southern Ethiopia.

Factors Determining Treatment Success in Children with Drug-Sensitive Tuberculosis in Ethiopia: A Three-Year Retrospective Analysis.

This study in the Amhara and Oromia regions of Ethiopia assessed the outcomes of tuberculosis (TB) treatment among children younger than 15 years. Retrospective data were collected on treatment outcomes and their determinants for children with TB for the cohorts of 2012-2014 enrolled in 40 hospitals and 137 health centers. Chi-square tests, -tests, and logistic regression were used for the analysis.

Identifying geographical heterogeneity of pulmonary tuberculosis in southern Ethiopia: a method to identify clustering for targeted interventions.

Background: Previous studies from Ethiopia detected disease clustering using broader geographic settings, but limited information exists on the spatial distribution of the disease using residential locations. An assessment of predictors of spatial variations of TB at community level could fill the knowledge gaps, and helps in devising tailored interventions to improve TB control.

Objective: To assess the pattern of spatial distribution of pulmonary tuberculosis (PTB) based on geographic locations of individual cases in the Dale district and Yirga Alem town in southern Ethiopia.

Patient and health system delay among TB patients in Ethiopia: Nationwide mixed method cross-sectional study.

Background: Effective tuberculosis (TB) control is the end result of improved health seeking by the community and timely provision of quality TB services by the health system. Rapid expansion of health services to the peripheries has improved access to the community. However, high cost of seeking care, stigma related TB, low index of suspicion by health care workers and lack of patient centered care in health facilities contribute to delays in access to timely care that result in delay in seeking care and hence increase TB transmission, morbidity and mortality.

Yield of household contact investigation of patients with pulmonary tuberculosis in southern Ethiopia.

Background: Household Contacts (HHCs) of patients with pulmonary tuberculosis (PTB) have a higher risk of developing TB. Contact investigation is recommended to reach this group and identify undiagnosed cases. In this study, we have determined the yield of contact investigation among HHCs of patients with smear-positive PTB, and estimated TB burden.

High urban tuberculosis case notification rates can be misleading: evidence from an urban setting in Ethiopia.

Background: Tuberculosis (TB) is a major public health problem. Its magnitude the required interventions are affected by changes in socioeconomic condition and urbanization. Ethiopia is among the thirty high burden countries with increasing effort to end TB.

Stigma matters in ending tuberculosis: Nationwide survey of stigma in Ethiopia.

Background: Tuberculosis (TB) affects, and claims the lives of, millions every year. Despite efforts to find and treat TB, about four million cases were missed globally in 2017. Barriers to accessing health care, inadequate health-seeking behavior of the community, poor socioeconomic conditions, and stigma are major determinants of this gap.

Implementation status of household contact tuberculosis screening by health extension workers: assessment findings from programme implementation in Tigray region, northern Ethiopia.

Background: In the Tigray region of Ethiopia, Health Extension Workers (HEWs) conduct Tuberculosis (TB) screening for all household (HH) contacts. However, there is limited evidence on implementation status of HH contact TB screening by HEWs. The aim of this program assessment was to describe the implementation status and associated factors of HH contact TB screening by HEWs.

Knowledge, attitudes, and practices related to TB among the general population of Ethiopia: Findings from a national cross-sectional survey.

Introduction: Ethiopia is among the high-burden countries for tuberculosis (TB), TB/HIV, and drug-resistant TB. The aim of this nationwide study was to better understand TB-related knowledge, attitudes, and practices (KAPs) and generate evidence for policy and decision-making.

Materials And Methods: We conducted a cross-sectional TB KAP survey in seven regions and two city administrations of Ethiopia.

Population-based screening for pulmonary tuberculosis utilizing community health workers in Ethiopia.

Objective: To evaluate the utility of a volunteer health development army in conducting population screening for active tuberculosis (TB) in a rural community in southern Ethiopia.

Methods: A population-based cross-sectional survey was conducted in six kebeles (the lowest administrative units). Volunteer women community workers led a symptom screening programme to identify adults ≥15 years of age with TB in the community.

Sub-national prevalence survey of tuberculosis in rural communities of Ethiopia.

Background: Tuberculosis is a major public health problem with varying prevalence in different settings. National prevalence surveys provide evidence for planning and decision making. However, they lack the capacity to estimate subnational magnitude that affected the capacity to make selected intervention based on the prevalence.

'The phone is my boss and my helper' - A gender analysis of an mHealth intervention with Health Extension Workers in Southern Ethiopia.

Background: There is considerable optimism in mHealth's potential to overcome health system deficiencies, yet gender inequalities can weaken attempts to scale-up mHealth initiatives. We report on the gendered experiences of an mHealth intervention, in Southern Ethiopia, realised by the all-female cadre of Health Extension Workers (HEWs).

Methodology: Following the introduction of the mHealth intervention, in-depth interviews (n = 19) and focus group discussions (n = 8) with HEWs, supervisors and community leaders were undertaken to understand whether technology acted as an empowering tool for HEWs.

How do gender relations affect the working lives of close to community health service providers? Empirical research, a review and conceptual framework.

Close-to-community (CTC) providers have been identified as a key cadre to progress universal health coverage and address inequities in health service provision due to their embedded position within communities. CTC providers both work within, and are subject to, the gender norms at community level but may also have the potential to alter them. This paper synthesises current evidence on gender and CTC providers and the services they deliver.

Correction: Long-term outcome of smear-positive tuberculosis patients after initiation and completion of treatment: A ten-year retrospective cohort study.

[This corrects the article DOI: 10.1371/journal.pone.

Exploring barriers to the use of formal maternal health services and priority areas for action in Sidama zone, southern Ethiopia.

Background: In 2015 the maternal mortality ratio for Ethiopia was 353 per 100,000 live births. Large numbers of women do not use maternal health services. This study aimed to identify factors influencing the use of maternal health services at the primary health care unit (PHCU) level in rural communities in Sidama zone, south Ethiopia in order to design quality improvement interventions.

Long-term outcome of smear-positive tuberculosis patients after initiation and completion of treatment: A ten-year retrospective cohort study.

Background: The status of tuberculosis (TB) patients since initiation of treatment is unknown in South Ethiopia. The objective of this study was to assess the long-term outcomes of smear-positive TB patients since initiation and completion of treatment, which includes TB recurrence and mortality of TB patients.

Methods: We did a retrospective cohort study on 2,272 smear-positive TB patients who initiated treatment for TB from September 1, 2002-October 10, 2012 in health facilities in Dale district and Yirgalem town administration.

Microbead-based spoligotyping of Mycobacterium tuberculosis from Ziehl-Neelsen-stained microscopy preparations in Ethiopia.

The worldwide dissemination of Mycobacterium tuberculosis strains has led to the study of their genetic diversity. One of the most used genotyping methods is spoligotyping, based on the detection of spacers in the clustered regularly interspaced short palindromic repeats (CRISPR) locus. This study assessed the performance of a microbead-based spoligotyping assay using samples extracted from Ziehl-Neelsen-stained smear-microscopy preparations and described the genetic diversity of Mycobacterium tuberculosis among new TB patients in Southern Nations, Nationalities and Peoples' Region (SNNPR) in Ethiopia.

Health extension workers improve tuberculosis case finding and treatment outcome in Ethiopia: a large-scale implementation study.

Background: Tuberculosis (TB) is a major cause of death in Ethiopia. One of the main barriers for TB control is the lack of access to health services.

Methods: We evaluated a diagnostic and treatment service for TB based on the health extension workers (HEW) of the Ethiopian Health Extension Programme in Sidama Zone, with 3.

Women health extension workers: Capacities, opportunities and challenges to use eHealth to strengthen equitable health systems in Southern Ethiopia.

Objectives: This study assesses the feasibility of female health extension workers (HEWs) using eHealth within their core duties, supporting both the design and capacity building for an eHealth system project focussed initially on tuberculosis, maternal child health, and gender equity.

Participants: Health extension workers, Health Centre Heads, District Health Officers, Zonal Health Department and Regional Health Bureau representatives in Southern Ethiopia.

Setting: The study was undertaken in Southern Ethiopia with three districts in Sidama zone (population of 3.

Patients direct costs to undergo TB diagnosis.

Background: A major impediment to the treatment of TB is a diagnostic process that requires multiple visits. Descriptions of patient costs associated with diagnosis use different protocols and are not comparable.

Methods: We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for diagnosis.