D Tollefson1, F Ngari2, M Mwakala2, D Gethi3, H Kipruto4, K Cain5, E Bloss1. 1. US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA. 2. National Tuberculosis, Leprosy, and Lung Disease Program, Nairobi, Kenya. 3. Kenya Medical Research Institute, Kisumu, Kenya. 4. World Health Organization, Nairobi, Kenya. 5. CDC, Kisumu, Kenya.
Abstract
BACKGROUND: Although an estimated three million tuberculosis (TB) cases worldwide are missed by national TB programs annually, the level of under-reporting of diagnosed cases in high TB burden settings is largely unknown. OBJECTIVE: To quantify and describe under-reporting of sputum smear-positive TB cases in Kenya. DESIGN: A national-level retrospective TB inventory study was conducted. All sputum smear-positive TB cases diagnosed by public or private laboratories during 1 April-30 June 2013 were extracted from laboratory registers in 73 randomly sampled subcounties and matched to TB cases in the national TB surveillance system (TIBU). Bivariate and multivariate analyses were conducted. RESULTS: In the subcounties sampled, 715 of 3409 smear-positive TB cases in laboratory registers were not found in TIBU. The estimated level of under-reporting of smear-positive TB cases in Kenya was 20.7% (95%CI 18.4-23.0). Under-reporting was greatest in subcounties with a high TB burden. Unreported cases were more likely to be patients aged ⩾55 years, have scanty smear results, and be diagnosed at large facilities, private facilities, and facilities in high TB burden regions. CONCLUSION: In Kenya, one fifth of smear-positive TB cases diagnosed during the study period went unreported, suggesting that the true TB burden is higher than reported. TB surveillance in Kenya should be strengthened to ensure all diagnosed TB cases are reported.
BACKGROUND: Although an estimated three million tuberculosis (TB) cases worldwide are missed by national TB programs annually, the level of under-reporting of diagnosed cases in high TB burden settings is largely unknown. OBJECTIVE: To quantify and describe under-reporting of sputum smear-positive TB cases in Kenya. DESIGN: A national-level retrospective TB inventory study was conducted. All sputum smear-positive TB cases diagnosed by public or private laboratories during 1 April-30 June 2013 were extracted from laboratory registers in 73 randomly sampled subcounties and matched to TB cases in the national TB surveillance system (TIBU). Bivariate and multivariate analyses were conducted. RESULTS: In the subcounties sampled, 715 of 3409 smear-positive TB cases in laboratory registers were not found in TIBU. The estimated level of under-reporting of smear-positive TB cases in Kenya was 20.7% (95%CI 18.4-23.0). Under-reporting was greatest in subcounties with a high TB burden. Unreported cases were more likely to be patients aged ⩾55 years, have scanty smear results, and be diagnosed at large facilities, private facilities, and facilities in high TB burden regions. CONCLUSION: In Kenya, one fifth of smear-positive TB cases diagnosed during the study period went unreported, suggesting that the true TB burden is higher than reported. TB surveillance in Kenya should be strengthened to ensure all diagnosed TB cases are reported.
Authors: S B Squire; A K Belaye; A Kashoti; F M L Salaniponi; C J F Mundy; S Theobald; J Kemp Journal: Int J Tuberc Lung Dis Date: 2005-01 Impact factor: 2.373
Authors: B Sai Babu; A V V Satyanarayana; G Venkateshwaralu; U Ramakrishna; P Vikram; S Sahu; F Wares; P K Dewan; K Santosha; J Jyoti; S Srinath; R Chethana; T Neelima; P Vinod; M Yogesh; L S Chauhan Journal: Int J Tuberc Lung Dis Date: 2008-09 Impact factor: 2.373
Authors: E Botha; S Den Boon; S Verver; R Dunbar; K-A Lawrence; M Bosman; D A Enarson; I Toms; N Beyers Journal: Int J Tuberc Lung Dis Date: 2008-07 Impact factor: 2.373
Authors: E Botha; S den Boon; K-A Lawrence; H Reuter; S Verver; C J Lombard; C Dye; D A Enarson; N Beyers Journal: Int J Tuberc Lung Dis Date: 2008-08 Impact factor: 2.373
Authors: P Angala; R A Dlodlo; S Wanjala; G Mamo; L Mugambi-Nyaboga; E Onyango Okoth; S Macharia; M Maina; S Wachira; K Owuor; E Masini; P Wekesa; E J Carter; B Mungai Journal: Public Health Action Date: 2022-03-21
Authors: Eunice W Mailu; Philip Owiti; Serge Ade; Anthony D Harries; Marcel Manzi; Eunice Omesa; Polly Kiende; Stephen Macharia; Irene Mbithi; Maureen Kamene Journal: Trans R Soc Trop Med Hyg Date: 2019-12-01 Impact factor: 2.184
Authors: Tao Li; Lijia Yang; Sarah E Smith-Jeffcoat; Alice Wang; Hui Guo; Wei Chen; Xin Du; Hui Zhang Journal: Int J Environ Res Public Health Date: 2021-02-25 Impact factor: 3.390
Authors: P S Lungu; M E Kabaso; R Mihova; A Silumesii; T Chisenga; C Kasapo; I Mwaba; A D Kerkhoff; M Muyoyeta; R Chimzizi; K Malama Journal: BMC Health Serv Res Date: 2022-08-22 Impact factor: 2.908