Tuberculosis situation in Ismailia governorate (2002–2012) before and after Direct Observed Therapy Short Course Strategy (DOTS)

Background: Tuberculosis (TB) is a major cause of illness and death worldwide, especially in Asia and Africa. In the early 1990s tuberculosis control in Egypt faced many problems. Major progress in global tuberculosis control followed the widespread implementation of the DOTS strategy. Aim: The objective of this work was to study the tuberculosis situation in the Ismailia governorate from 2002 to 2012 before and after Direct Observed Therapy Short Course Strategy (DOTS). Methods: This was a retrospective clinical cohort study carried out at the Ismailia governorate. The registered data about all TB cases over a period of 10 years (2002–2012) before and after the application of DOTS were collected from the chest hospital and TB registration units. Percentages of cure treatment significantly increased after DOTS (55.3%) than before (40.5%) (P < 0.01). On the other hand, complete, failure, death, default and transfer out decreased after DOTS (32.5%, 1.3%, 6.3%, 2.5% and 2.0% respectively) than before it (38.7%, 3.1%, 6.9%, 7.2% and 4.0% respectively), the results were not significant (P > 0.05) for all of them. The mean values of incidence rates (new and relapse cases, all cases and new smear positive pulmonary TB cases) of TB highly significantly (P < 0.01) decreased after the application of DOTS for all of them except new smear positive pulmonary TB cases (P > 0.05). Also, the cure rate and treatment success rate significantly increased (P < 0.05), while retreatment TB cases rate, default rate, transfer out rate and retreatment failure rate did not significantly decreased (P > 0.05) for all of them except retreatment failure rate (chronic TB rate) (P < 0.05). Finally new pulmonary TB cases with no smear result significantly (P < 0.05) decreased after DOTS. Conclusion: The introduction of DOTS in the Ismailia governorate has led to a significant increase in the treatment success (88.07%) which is higher than the WHO target (85%), and a decrease in the default and failure rates