Background. In Ethiopia, the national TB case detection rate is becoming improved; still some districts are not able to meet their case detection targets which leads to ongoing spread of TB infections to family members and communities. This study was intended to assess possible obstacles contributing to low TB case detection in Kaffa zone, Southwest Ethiopia. Methods. A cross-sectional descriptive study involving qualitative and quantitative data was conducted from Mar. to Sep. 2019. Sociodemographic characteristics and data on duration of cough, whether sputum smear microscopy was requested or not, and data on TB knowledge and health care-seeking practice were collected from outpatients. Health care delivery barrier for TB case detection was also explored by using in-depth interview and FGD of health staff. Results. From 802 outpatients with coughing for 2 or more weeks of duration, 334 (41.6%) of them were not requested to have TB microscopic diagnosis. Of these, 11/324 (3.4%) of them were positive for TB after sputum smear microscopy. Only 24.2% of the outpatients were aware as they have had health education on TB disease. Twenty-eight percent of patients perceived that TB was due to exposure to cold air, and 13.5% could not mention any sign or symptom of TB. Amazingly, 54.2% of them did not have any information as current TB diagnosis and treatment is free. Thirty-five percent of the patients were taking antibiotics before visiting the health facility. The interrupted supply of TB diagnostic reagents, frequent electricity interruption, shortage of trained TB care providers, weak health information system, and weak active case finding practice were explored as the factors contributing to low TB case detection. Conclusion. Interrupted functioning of diagnostic centers, shortage of trained care providers, limited active TB case finding practice, weak health information system, and inadequate knowledge and health care-seeking practice of the patients were identified as contributors for low TB case detection. Thus, improving functioning of diagnostic centers, active TB case finding activities, and expanding health education on TB disease will help to improve TB case detection in the districts.

中文翻译：

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低结核病 (TB) 病例检测：基于卫生设施的埃塞俄比亚西南区卡法区可能障碍的研究。

背景。在埃塞俄比亚，全国结核病病例检出率正在提高；仍有一些地区无法实现病例检测目标，导致结核病感染持续向家庭成员和社区传播。本研究旨在评估导致埃塞俄比亚西南部卡法地区结核病病例检测率低的可能障碍。方法. 一项涉及定性和定量数据的横断面描述性研究于 2019 年 3 月至 9 月进行。社会人口学特征和咳嗽持续时间数据、是否要求进行痰涂片镜检、结核病知识和就医实践数据是从门诊病人那里收集的。还通过使用深度访谈和卫生人员的 FGD 探索了结核病病例检测的卫生保健提供障碍。结果. 802 例咳嗽 2 周及以上的门诊患者中，334 例（41.6%）未要求进行结核病显微诊断。其中，11/324 (3.4%) 人在痰涂片镜检后呈结核病阳性。仅24.2%的门诊患者因接受过结核病健康教育而知晓。28% 的患者认为结核病是由于暴露于冷空气所致，13.5% 的患者无法提及结核病的任何体征或症状。令人惊讶的是，其中 54.2% 的人没有任何信息，因为目前的结核病诊断和治疗是免费的。35% 的患者在就诊前服用了抗生素。结核病诊断试剂供应中断，电力中断频繁，训练有素的结核病护理人员短缺，卫生信息系统薄弱，结论。诊断中心的运作中断、训练有素的护理提供者短缺、积极的结核病病例发现实践有限、卫生信息系统薄弱以及患者的知识和就医实践不足被确定为结核病病例发现率低的原因。因此，改善诊断中心的功能、积极开展结核病病例发现活动以及扩大结核病健康教育将有助于提高地区结核病病例的发现水平。