Analysis of tuberculosis cases notification and treatment outcomes in refugee camps in Kenya: Four-years retrospective study, 2014-2017

Analysis of tuberculosis cases notification and treatment outcomes in refugee camps in Kenya: Four-years retrospective study, 2014-2017

Tsegay Legesse¹, Stephen Mulesh², Dorothy Anjuri³, Miriam Ngure³, Salad Chiari³, Fredrick Chepkwong³, Job Okemwa², Adbirushid Diney², Abdillah Frah², Fathia Alwan¹ & Desta Kassa¹

¹Intergovernmental Authority on Development, Djibouti

²Ministry of Health, National TB program, Kenya

³Kenya Red Cross Society, Kenya

*Corresponding Author: Desta Kassa, Intergovernmental Authority on Development, Djibouti, Email: dkassa2003@gmail.com

Received date: 02 November, 2021 Accepted date: 23 November, 2021 Published Date: 29 November, 2021

Citation: Legesse T, Mulesh S, Anjuri D, Ngure M, Chiari S, et al. (2021) Analysis of tuberculosis cases notification and treatment outcomes in refugee camps in Kenya: Four-years retrospective study, 2014-2017. Sci J Health Sci Res Vol: 1, Issu: 1 (39-48).

Abstract

Background: Tuberculosis (TB) is more severe in refugee populations. Analyzing the key indicators of TB program performance is important to improve the TB control activities. The objective of this study was to assess trends in TB case notification, treatment outcomes and factors associated with unsuccessful TB treatment in Dadaab and Kakuma refugee camps in Kenya.

Methods: In this descriptive historical cohort study, demographic, type of TB, & patient, related clinical data and treatment outcome of all TB cases registered in the five health facilities at the refugee camps from January 1, 2014 to December 31, 2017 were extracted. Multivariable logistic regression analysis was used to identify factors associated with unsuccessful TB treatment.

Results: A total of 2055 TB cases were registered in Dadaab and Kakuma refugee camps. The annual TB case notification rate (CNR) per 100 000 population increased from 93.1 in 2015 to 130.9 in 2017. From 2014 to 2017, there was an increase in proportion of Extra pulmonary TB (EPTB) (16.2% to 21.1%) and contribution of children (<15 years) to total TB cases (20.3% to 25.8%). Proportion of bacteriologically confirmed new and relapse Pulmonary TB (PTB) patients increased from 49.5% to 60.9%. The annual treatment success rate was in the range of 92.6% to 94.4% over the four years. Overall, 2.2% were died (decreasing from 2.4% to 1.6%), 1.6% not evaluated (decreasing from 3.2% to 1.3%), 2.3% lost to follow-up (LTFU) (increasing from 1.3% to 3.2%), and 0.5% were treatment failed. Unsuccessful Analysis of tuberculosis cases notification and treatment outcomes in refugee camps in Kenya: Four-years retrospective study, 2014-2017 treatment outcome was significantly associated with pretreatment weight <40 Kg, male gender, smear positive PTB, and HIV infection.

Conclusions: From 2014 to 2017, there was a continuous increase in TB CNR, and in proportion of EPTB and childhood TB. Treatment success rate remained above global target (?90%) as set by WHO, which should be maintained. Special support and close monitoring are required for TB patients who are at higher risk of unsuccessful treatment.

Keywords: Tuberculosis, Refugees, Case notification, Treatment outcome.