Tuberculosis at Mahalla El - Koubra Town: a study of some epidemiological features

ABSTRACT

Tuberculosis is considered the most important resurgent disease worldwide. In 1993 WHO declared the worsening TB epidemic a global health emergency. This longitudinal incidence study was conducted to study some epidemiological features of newly diagnosed cases of tuberculosis and treatment outcome at Mahalla El-Koubra town during the years 1996,1997 and1998. The overall incidence rate of tuberculosis cases among total cases presented with chest complaints in the two Mahalla El-Koubra chest dispensaries decreased significantly from 3.315/1000 examined cases in 1996 to 1.301/1000 in 1998. The proportion of smear-positive case detection however has significantly increased during study period from 57.33% in 1996 to 70.63% in 1998. Extrapulmonary TB, mainly TB pleural effusion and TB lymphnodes also increased from 15.46% in 1996 to 17.99% in 1998. Male patients represented 65.48% of cumulative total. Before the age of 15 years, female TB patients were more than male patients while during the age group 15-45 years the reverse was found. However, these differences were found to be statistically not significant. Cure rates significantly improved from 1996 to 1998. On the other hand treatment failure and defaulting significantly decreased. Short-term treatment was found to have higher favorable outcomes [completed and cure] as compared to standard treatment and retreatment. Incidence of TB cases was declining at Mahalla El-Koubra during the study period. Short-term treatment implemented at Mahalla El-Koubra chest dispensaries proved to yield better outcomes. Directly observed therapy-short course [DOTS] strategy recommended by WHO is being recently employed as a treatment modality at Mahalla El-Koubra chest dispensaries. Continuous surveillance of TB is essential to validate and ensure an actual decrease in TB incidence and for evaluation of treatment outcome of DOTS strategy