Files
Abstract
Statement of the problem: Tuberculosis is the one of the leading causes of death among infectious diseases in the world. Although the TB epidemic is generally higher in Sub-Sahara Africa, it is not uniform among all the populations in this region. It is not known whether incidence of TB and TB treatment outcomes are similar between rural and urban settings in Sub-Sahara Africa. Goal: The main goal of our study is to improve TB control by describing the incidence and TB treatment outcomes in rural and urban ZambiaMethods: In the first 2 specific aims we performed a retrospective cohort analysis of data from the TB control program in southern Zambia. We assessed the association between unfavorable TB treatment outcomes and rural/urban setting among new and recurrent TB patients. In the third aim we compared the incidence of TB between rural and urban settings among HIV seropositive individuals on ART in Zambia. Results: Among 21,057 new TB patients rural health setting was associated with death (aOR: 1.3; 95% CI; 1.0 1.5). Similarly, in recurrent TB in rural areas were more likely to die during the time of TB treatment than their counterparts in the urban settings ((aOR: 1.7; 95% CI: 1.0 - 2.7). There was no difference in TB incidence among HIV seropositive individuals on ART between rural and urban settings ((aHR =1.4, 95% CI: 0.4 1.7). The overall incidence rate was high in both rural and urban settings (IR: 2.07/1000PYO; 95% CI: 1.83.7).Conclusion Rural setting was associated with poor TB treatment outcomes. The incidence of TB was high in both rural and urban settings. TB control officers must adapt TB control strategies according to the setting.