The Dwindling Public Health Hazard of Ethiopia: TB
The United Nations has estimated that over 10 million people are infected with tuberculosis (TB). For many years from now, studies have shown that TB is the leading cause of death among people with HIV and also a major contributor to antimicrobial resistance. According to a report by the WHO, although people who fall ill with TB live in low- and middle-income countries, the disease is prevalent all across the world. Surprisingly, reports have been made that half of all people with TB are found in 8 countries of the world: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa. Despite numerous national and international attempts to prevent and control TB, the disease remains a major global public health concern, particularly among the low- and middle-income countries.
Nevertheless, a study has revealed that Ethiopia is achieving better in the fight against TB. The study, basically, aimed to estimate the burden of TB among HIV-negative individuals in Ethiopia from the year 1990 up to 2019 with gender, age group, status of drug resistance, and regions. To do so, it used some data from the Global Burden of Disease Study (GBD) 2019. In that regard, the major findings of the study have revealed that, first, among both sexes, the majority of incident cases are 93% and the deaths are 69% among people under the age of 65. Second and most importantly, the Annualized Rate of Change (ARC) in age-standardized TB incidence has decreased by 2.2% from 1990 to 2015. Besides, a 0.05% decrement was observed from 2016 to 2019 in the ARC. Third, the ARC in mortality from XDR-TB was 0.23%, from 2016 to 2019, which is a higher rate of decrement than the 16.8% increase seen from 1990 to 2015. According to the discussion, in 2019, Dire Dawa reported the lowest age-standardized TB incidence rate of 192 per 100,000 populations while Afar reported the highest 425 per 100,000, and that has made the burden of TB decrease for both regions compared to the years before 2019. Moreover, all regions of Ethiopia, except Somali, Gambella, and SNNPs show a slower rate of decline in ARC in mortality between the years 1990-2015.
Figure 1. Age-standardized tuberculosis mortality rate (per 100,000 populations) across regional states from 1990 to 2019
In essence, the study has briefly shown that there is a declining trend in TB burden among HIV-negative individuals in Ethiopia from 1990 to 2019. Indeed, the improvement could be attributed to the significant progress that occurred in TB prevention and control, with resources and decentralized primary health care actions. However, efforts are still needed to ensure that Ethiopia is not left behind in the current global move to end TB.