Background
Methods
Study area
Data sources
Tuberculosis data
Treatment Outcomes | Definitions |
---|---|
Cured | A pulmonary TB patient with bacteriologically confirmed TB at the beginning of treatment who was smear- or culture-negative in the last month of treatment and on at least one previous occasion. |
Treatment completed | A TB patient who completed treatment without evidence of failure but with no record to show that sputum smear or culture results in the last month of treatment and on at least one previous occasion were negative, either because tests were not done or because results are unavailable. |
Treatment failure | A TB patient whose sputum smear or culture is positive at month 5 or later during treatment. |
Death | A TB patient who dies for any reason during the course of treatment. |
Lost to follow-up | A TB patient whose treatment was interrupted for two consecutive months or more. |
Poor treatment outcome | The sum of failure, death and lost to follow up. |
Treatment success | The sum of cured and treatment completed. |
Independent variables
Independent variables | Data sources | Definition |
---|---|---|
Socio-economic factors | ||
Low wealth index | EDHS 2016 | Total number of people with low wealth index (poorer and poorest) divided by the total number of people participated in the survey. |
Population density | Ethiopia Atlas of Population Density | Number of people per square kilometre |
Dependency ratio | Ethiopia Atlas of Population Density | Number of children (aged under 15 years) and elderly (aged 65+) dividing by the working-age population (aged 15–64 years) |
Average number of persons per room | Ethiopia Atlas of Population Density | Average number of people living in a room |
Unemployed population | Ethiopia Atlas of Population Density | Percentage of people in the labour force who were unemployed |
Adult literacy rate | Ethiopia Atlas of Population Density | Percentage of population aged 15 years and above who had attended higher than secondary school or who can read and write a short simple statement |
Behavioural factors | ||
Chat chewing | EDHS 2016 | Total number of people chewing chat in the last 1 month prior to the survey divided by the total number of people participating in the survey |
Alcohol drinking | EDHS 2016 | Total number of people drinking alcohol in the month prior to the survey divided by the total number of people participating in the survey |
Health care access and knowledge and attitude regarding TB | ||
Health care access problem | EDHS 2016 | Difficulty of getting advice or treatment due to lack of money, or distance to a health facility |
Good knowledge toward TB | EDHS 2011 | Number of people with good knowledge towards TB divided by the total number of people participating in the survey. |
Good attitude towards TB | EDHS 2011 | Number of people with good attitude towards TB divided by the total number of people participating in the survey |
Climatic and environmental factors | ||
Enhanced vegetation index | EDHS Spatial Analysis data | The average enhanced vegetation index which is calculated by measuring the density of green leaves in the near-infrared and visible bands. |
Rainfall | EDHS Spatial Analysis data | Annual mean rainfall (mm) |
Aridity | EDHS Spatial Analysis data | The average aridity index calculated by dividing the actual evapotranspiration by the potential evapotranspiration. |
Mean temperature | EDHS Spatial Analysis data | Annual mean environmental air temperature (°C). |
Knowledge and attitudes regarding TB
Health care access
Behavioural factors
Socio-economic factors
Climatic and environmental factors
Non-spatial statistical analyses
Spatial autocorrelation analysis
Bayesian spatial analysis
Results
Tuberculosis treatment outcomes in Ethiopia
Spatial clustering of poor TB treatment outcomes in Ethiopia
Factors associated with poor TB treatment outcomes
Independent variables | Coefficient (95% CI) | P-value |
---|---|---|
Socio-economic factors | ||
Low wealth index | 0.01 (0.005, 0.016) | < 0.001 |
Population density | 0.00002 (−0.00004, 0.00009) | 0.429 |
Dependency ratio | −1.01 (−1.85, − 0.192) | 0.016 |
Average number of persons per room | 0.23 (0.11, 0.350) | 0.001 |
Unemployed population | 0.0535 (0.025, 0.082) | < 0.001 |
Adult literacy rate | −0.0088 (− 0.013, − 0.0002) | 0.045 |
Behavioural factors | ||
Chat chewing | −0.011 (− 0.02, − 0.003) | 0.011 |
Alcohol drinking | − 0.0039 (− 0.009, 0.001) | 0.115 |
Health care access | ||
Health care access problem | −0.0001 (− 0.01, 0.008) | 0.995 |
Poor knowledge towards TB | 0.003 (0.0015, 0.009) | 0.046 |
Poor attitude towards TB | 0.002 (−0.007, 0.012) | 0.653 |
Climatic factors | ||
Enhanced vegetation index | −0.0001 (− 0.0003, −6.59e-06) | 0.041 |
Rainfall | −0.0001 (− 0.0003, −4.93e-06) | 0.044 |
Aridity | − 0.0001 (− 0.0001, − 0.00003) | 0.001 |
Mean temperature | 0.133 (0.09, 0.168) | < 0.001 |
Variables | Unstructured model | Structured model | Structured & unstructured model | Model without covariates |
---|---|---|---|---|
OR, Posterior Mean (95% CrI | OR, Posterior Mean (95% CrI | OR, Posterior Mean (95% CrI | ||
Chat chewing | 0.99 (0.98, 1.00) | 0.99 (0.98, 1.00) | 0.99 (0.98, 1.00) | – |
Low wealth index |
1.01 (1.00, 1.01)
|
1.01 (1.00, 1.01)
|
1.01 (1.00, 1.01)
| – |
Knowledge towards TB |
1.02 (1.01, 1.03)
|
1.013 (1.00, 1.03)
|
1.02 (1.01, 1.03)
| – |
Mean temperature |
1.15 (1.08, 1.21)
|
1.12 (1.045, 1.18)
|
1.14 (1.08, 1.20)
| – |
Constant (alpha) | −5.57 (−6.64, −4.39) | −5.04 (− 6.17, −3.74) | − 5.48 (− 6.51, − 4.37) | −2.11 (−2.14, −2.07) |
Heterogeneity | ||||
Unstructured variance | 0.63 (0.53, 0.74) | – | 0.24 (0.028, 0.83) | |
Structured variance | – | 1.264 (1.07, 1.50) | 0.59 (0.42, 0.73) | 1.57 (1.34, 1.84) |
DIC | 746.0 | 764.5 | 752.0 | 760.8 |