Research Article
Characteristics and Treatment Outcomes of (Transfer Out)
TB Patients after Crosschecking Registers at Four Hospitals of
Tigray Regional State, Ethiopia: 2011-2015
Haftamu Hailekiros ,
1
Mahmud Abdulkader Mahmud,
1
and Alemayehu Bayray Kahsay
2
1
Mekelle University College of Health Sciences, Department of Microbiology and Immunology, 1871, Ethiopia
2
Mekelle University College of Health Sciences, School of Public Health, Department of Epidemiology, 1871, Ethiopia
Correspondence should be addressed to Hafamu Hailekiros; habtkinf19@gmail.com
Received 16 January 2019; Revised 13 May 2019; Accepted 4 June 2019; Published 24 June 2019
Academic Editor: Jos´ e R. Lapa e Silva
Copyright © 2019 Hafamu Hailekiros et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Globally, transferring TB patients to another health unit for treatment continuation is common trend while posing challenges for
proper treatment outcomes monitoring. National guidelines indicated the importance of incorporating the treatment outcomes of
those cases by the transferring unit when performing annual cohort analysis. However, in most instances, this is not taken into
account. Tis study was conducted to determine the characteristics and treatment outcomes of ‘transfer out’ TB cases during the
time period between 2011 and 2015 at four Hospitals of Tigray: Ethiopia. Initial data was extracted from TB treatment logbooks of
transferring units using standardize checklist that were followed by a visit to each of the receiving units. Te generated data were
entered and analyzed using SPSS v. 22.0. Descriptive statistics were computed. P-value less than 0.05 were considered statistically
signifcant. A total of 143 TB patients were transferred out during the specifed time period whereas 73.4% (105/143) patients were
traced and classifed as “arrivals”. From these, more than three-quarters, 87.6% (92/105), of patients had a successful treatment
outcome (5.7% cured and 81.9% completed treatment) while 13/105 (12.3%) had an unsuccessful outcome (2.8% defaulted, 5.7%
died, 1.9% failed, and 1.9% transferred out). However, none of the transferring unit received and traced status of the cases. Terefore,
regular monitoring is needed to improve the existing communication gap.
1. Introduction
Tuberculosis (TB) is worldwide public health problem, more
importantly; its burden remains to be enormous in devel-
oping countries. In Ethiopia, the TB case notifcation and
detection rate are improving over the years [1]. According
to the Ethiopian national TB guideline, all patients either
clinically judged or bacteriologically confrmed should start
treatment without delay under Directly Observed Treatment-
short course (DOTS) [2]. However, it is fairly common for TB
patients to seek treatment services at health facility other than
where they initially diagnosed [3].
A transfer out patient (TO) is a patient who has been
transferred out at any time during treatment to continue
treatment at another facility [4]. Such intracountry move-
ment of patients, from one treatment unit to another, for
various reasons poses challenge for efective implementation
of TB control programs worldwide [5]. Reports depicted that
there are substantial variation interims of the proportion
of TO patients from one country to another; for instance,
in Sub-Saharan Africa countries it ranges from 1% to 26%
[6, 7], while higher rates, 31% to 66%, have been previously
reported from Ethiopia [8–10]. A research study conducted in
Gondor, Ethiopia, also showed that 42% of TB patients were
transferred out between 2003 and 2008 from a University
hospital to continue their treatment at nearby health units [9].
Te National TB program (NTP) guidelines indicate the
necessity of incorporating treatment outcome of transfer
out TB patients and reporting regularly to the national
surveillance system by the transferring unit, as this unit
notifed and initiated treatment for this patient. However,
essentially this is not done in most settings [11–13]. Moreover,
Hindawi
Tuberculosis Research and Treatment
Volume 2019, Article ID 1761694, 6 pages
https://doi.org/10.1155/2019/1761694