A Study of Quarterly Trend of Infectious Tuberculosis and Evaluation of Tuberculosis Control Program in Post Conflict Sierra Leone, 2002-2005

This study aimed to measure the impact of directly observed treatment short-course (DOTS) coverage on notification of infectious tuberculosis (TB) and treatment cure rate in the post conflict period of 2002 to 2005 in Sierra Leone. The study was a population based retrospective study on implementation of DOTS expansion by the National Leprosy TB Control Program (NLTCP). Data recorded in district TB registers and TB annual reports were analysed for trend of infectious TB registered quarterly, treatment cure rates and number DOTS centres opened per annum. A trend analysis of proportion of infectious TB (sputum smear positive) to all TB cases reported to the central program each quarter during the periods 2002 to 2005 was plotted. However, this did not appear to show any discernable pattern but the following observations were made. In 2003 the lowest proportion of infectious TB cases was reported. Furthermore, there appeared to be a decline in proportion of infectious TB cases reported in the third quarter of each year, corresponding to the peak of the rainy season. An evaluation of DOTS expansion based on Donabedian’s triad showed that 76% of the target set for 2005 was achieved; that is, 53 of the targeted 70 DOTS centres were opened by the end of 2005. A correlation-regression analysis gave a correlation coefficient (R) of 0.22 which suggests a weak relationship between treatment cure rate and district population DOTS coverage. The implementation of DOTS expansion by the NLTCP considerably improved DOTS coverage and treatment cure rates in the immediate post conflict period of 2002 to 2005. However, there was a weak association between district DOTS coverage and treatment cure rates, and its impact on trend of infectious TB notification was limited during this period