Tuberculosis Control

Even if 36 million patients with tuberculosis were successfully treated and up to 6 million lives were saved during the past 15 years, tuberculosis remains a major public health problem. Still, more than 9 million cases occur every year. Unfortunately, only about half of the expected cases are identified yearly and receive proper care.

Our research group works to develop novel interventions to diagnose, treat, and thus stop transmission of tuberculosis (see list of publications). Through operational research we aim to improve public health interventions and treatment of diseases in real-life situations.

Most recently we asked: Is active case finding necessary to control tuberculosis in developing countries? In a series of papers, Daniel Datiko Gemetchu documented that involving of health extension workers (HEWs) in sputum collection and treatment improved smear-positive case detection and treatment success rate, possibly because of an improved service access. This finding has policy implications and could be applied in settings with low health service coverage and a shortage of health workers.

Recently, National TB Control Programme in Ethiopia started to decentralize case finding and treatment to local communities (in Ethiopia called kebeles) using community based-treatment by health extension workers.

We now plan to follow up our earlier studies and develop a model for community DOTS in rural Ethiopia. We will try to develop community-based tuberculosis registries, and registries of patients with symptoms suggestive of tuberculosis.  Through this work we aim to see if active case finding and treatment outcomes can be improved on a larger scale and involving larger populations

Publications on tuberculosis:

PhD work:

Hamusse SD. Tuberculosis Control in Arsi in Ethiopia: Programme Performance and Disease Burden.  PhD. University of Bergen, 2017. Bergen

Dangisso MH. Tuberculosis control in Sidama in Ethiopia. Programme performance and spatial epidemiology [PhD]. Bergen: University of Bergen; 2016.

Datiko DG. Improving Tuberculosis Control in Ethiopia: performance of TB control programme, community DOTS and its cost-effectiveness [PhD]. Bergen: University of Bergen; 2011.

Shargie E. Trends, challenges and opportunities in tuberculosis control in rural Ethiopia : Epidemiological and operational studies in a resource-constrained setting [PhD]. Bergen: University of Bergen; 2007.

Jerene D. HIV antiretroviral therapy in Ethiopia. Overcoming implementation challenges [PhD]. Bergen: University of Bergen; 2007.

Demissie M. Challenges of Tuberculosis Control in Ethiopia [PhD]. Bergen: University of Bergen; 2002.

Madebo T. Clinical and operational challenges in the control of tuberculosis in south Ethiopia [PhD]. Bergen: University of Bergen; 2002.


Scientific articles:

Hamusse S, Demissie M, Teshome D, Hassen MS, Lindtjorn B. Prevalence and Incidence of Smear-Positive Pulmonary Tuberculosis in the Hetosa District of Arsi Zone, Oromia Regional State of Central Ethiopia. BMC infectious diseases. 2017;17(1):214.

Uppada DR, Selvam S, Jesuraj N, Lau EL, Doherty TM, Grewal HMS, Vaz M, Lindtjørn B: Incidence of tuberculosis among school-going adolescents in South India. BMC Public Health 2016, 16:1-11.

Hamusse S, Teshome D, Hussen M, Demissie M, Lindtjorn B. Primary and secondary anti-tuberculosis drug resistance in Hitossa District of Arsi Zone, Oromia Regional State, Central Ethiopia. BMC Public Health 2016; 16(1):

Dangisso MH, Gemechu Datiko D, Lindtjørn B. Accessibility to tuberculosis control services and tuberculosis programme performance in southern Ethiopia. Global health action 2015; 8(0).

Dangisso MH, Datiko DG, Lindtjørn B (2015) Spatio-Temporal Analysis of Smear-Positive Tuberculosis in the Sidama Zone, Southern Ethiopia. PLoS One 2015; 10(6): e0126369.

Dangisso, MH, Datiko DG and Lindtjørn B. (2015). Low case notification rates of childhood tuberculosis in southern Ethiopia. BMC Pediatr 15(1): 1-10.

Woldesemayat EM, Datiko DG, Lindtjørn B. Follow-Up of Chronic Coughers Improves Tuberculosis Case Finding: Results from a Community-Based Cohort Study in Southern EthiopiaPLoS ONE 2015; 10(2): e0116324.

Dangisso MH, Datiko DG, Lindtjorn B. Trends of tuberculosis case notification and treatment outcomes in the Sidama Zone, southern Ethiopia: ten-year retrospective trend analysis in urban-rural settings. PloS ONE 2014; 9(12): e114225.

Westerlund E, Jerene D, Mulissa Z, Hallstrom I, Lindtjorn B. Pre-ART retention in care and prevalence of tuberculosis among HIV-infected children at a district hospital in southern Ethiopia. BMC pediatrics 2014; 14(1): 250.

Hamusse SD, Demissie M, Teshome D, Lindtjorn B. Fifteen-year trend in treatment outcomes among patients with pulmonary smear-positive tuberculosis and its determinants in Arsi Zone, Central Ethiopia. Global health action 2014; 7: 25382.

Hamusse SD, Demissie M, Lindtjorn B. Trends in TB case notification over fifteen years: the case notification of 25 Districts of Arsi Zone of Oromia Regional State, Central Ethiopia. BMC public health 2014; 14: 304.

Woldesemayat EM, Datiko DG, Lindtjorn B. Use of biomass fuel in households is not a risk factor for pulmonary tuberculosis in South Ethiopia. The international journal of tuberculosis and lung disease : 2014; 18(1): 67-72.

Mulissa Z, Jerene D, and Lindtjørn B. Patients Present Earlier and Survival Has Improved, but Pre-ART Attrition Is High in a Six-Year HIV Cohort Data from Ethiopia. PLoS ONE 5(10): e13268. doi:10.1371/journal.pone.0013268

Datiko, D. G. (2011). Improving Tuberculosis Control in Ethiopia: Performance of TB control programme, community DOTS and its cost-effectiveness. Centre for International Health. Bergen, University of Bergen. PhD: 162.

Datiko DG, Lindtjørn B. Mortality in successfully treated TB patients in southern Ethiopia: retrospective post-treatment follow up study. The International Journal of Tuberculosis and Lung Disease, 2010, 14 (7): 866-871

Datiko DG, Lindtjørn B. Cost and cost-effectiveness of smear-positive tuberculosis treatment by health extension workers in southern ethiopia: a community randomized trial. PLoS One. 2010;5(2):e9158. ( ID: NCT00913172)

Datiko DG, Lindtjørn B. Tuberculosis recurrence in smear-positive patients cured under DOTS in southern Ethiopia: retrospective cohort study. BMC Public Health 2009, 9:348

Datiko DG, Lindtjørn B. Health Extension Workers Improve Tuberculosis Case Notification and Treatment Success in Southern Ethiopia: A Community-Randomized Trial PLoS ONE 2009; 4(5): e5443. doi:10.1371/journal.pone.0005443. NCT00803322.

Datiko DG, Yassin MA, Chekol LT, Kabeto LE, Lindtjørn B. The rate of TB-HIV co-infection depends on the prevalence of HIV infection in a community. BMC Public Health. 2008;8:266.

Shargie EB, Lindtjørn B. Determinants of treatment adherence among smear-positive pulmonary tuberculosis patients in Southern Ethiopia. PLoS Med. 2007;4:e37.

Demissie M, Omer OA, Lindtjørn B, Hombergh J. 2006  “Tuberculosis” in Berhane Y, Hailemariam D and Kloos (Eds) The Epidemiology and Ecology of Health and Disease in Ethiopia.  Page  409-434. Addis Ababa: Shama Books

Jerene D, Naess A, Lindtjørn B. Antiretroviral therapy at a district hospital in Ethiopia prevents death and tuberculosis in a cohort of HIV patients. AIDS Res Ther. 2006;3:10.

Shargie EB, Mørkve O, Lindtjørn B. Tuberculosis case-finding through a village outreach programme in a rural setting in southern Ethiopia: community randomized trial. Bull World Health Organ. 2006;84:112-9.

Shargie EB, Yassin MA, Lindtjørn B. Prevalence of smear-positive pulmonary tuberculosis in a rural district of Ethiopia. Int J Tuberc Lung Dis. 2006;10:87-92.

Shargie EB, Lindtjørn B. DOTS improves treatment outcomes and service coverage for tuberculosis in South Ethiopia: a retrospective trend analysis. BMC Public Health. 2005;5:62.

Shargie, Estifanos Biru; Yassin, Mohammed Ahmed; Lindtjørn, Bernt. Quality control of sputum microscopic examinations for acid fast bacilli in southern Ethiopia. Ethiopian Journal of Health Development 2005;19(2):104-108.

Madebo T, Lindtjørn B, Aukrust P, Berge RK. Circulating antioxidants and lipid peroxidation products in untreated tuberculosis patients in Ethiopia. Am J Clin Nutr. 2003;78:117-22.

Demissie M, Getahun H, Lindtjørn B. Community tuberculosis care through “TB clubs” in rural North Ethiopia. Soc Sci Med. 2003;56:2009-18.

Demissie M and Lindtjørn B. Gender perspective in health: does it matter in tuberculosis control? Ethiop J Hlth Dev 2003; 17: 239-243Demissie M, Zenebre B, Berhane Y and Lindtjørn B. Rapid survey to determine the prevalence of smear positive pulmonary tuberculosis in Addis Ababa. Int J Tuberc Lung Dis, 2002,6(7): 1-5.

Demissie M, Berhane Y and Lindtjørn B. Patient and Health Service delay in the diagnosis of pulmonary tuberculosis patients in Addis Ababa. BMC Public Health 2002 2:23.

Lindtjørn B, Madebo T. The outcome of tuberculosis treatment at a rural hospital in south Ethiopia. Tropical Doctor 2001; 31(3): 132-5

Demissie M, Lemma E, Gebeyehu M and Lindtjørn B. Sensitivity to anti TB drugs in HIV positive and negative TB patients. Scan J Infect Dis 2001; 33: 914-919.

Demissie M, Lindtjørn B and Tegbaru B. Human Immunodeficiency Virus infection in tuberculosis patients in Ethiopia. Ethiop J Hlth Dev 2000; 14(3): 277-282.

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