The Ethiopian initiative to build sustainable capacity for operational research: overview and lessons learned

SETTING

Programme-based operational research is instrumental for the enhancement of tuberculosis (TB) control. In 2012, the Ethiopian Federal Ministry of Health launched an initiative for capacity building in operational research (OR).

OBJECTIVE

To develop sustainable capacity for OR in Ethiopia in a multiyear initiative.

DESIGN

The initiative was developed in collaboration with regional, national and international experts. Teams representing regions in Ethiopia conducted OR addressing national and regional priorities. To make use of local expertise and increase sustainability, a domestic mentor training programme was included. Existing capacity was enhanced through a competitive grant scheme providing TB researchers with financial and technical support. The Ethiopian Tuberculosis Research Advisory Committee was also supported in its functions. Regional ethics review bodies were strengthened or established where they did not exist.

RESULTS

Fifty-two people were trained and conducted 13 OR projects, of which six have been published to date. In addition, eight protocols were supported through grants. Ethics review bodies were strengthened in all regions.

CONCLUSION

The initiative trained participants from all regions and succeeded in the completion of all stages of the OR process. The success of the programme can be attributed to the team approach, 'learning while doing', integrated mentorship programme and strong national ownership.

Knowledge and practice of private practitioners in TB control in Addis Ababa

SETTING

Private clinics and hospitals in Addis Ababa, Ethiopia.

OBJECTIVES

To assess the knowledge of private practitioners (PPs) with regard to tuberculosis (TB) control and their practice of TB diagnosis, treatment and monitoring.

DESIGN

A descriptive survey was conducted among PPs. A total of 120 responded to a self-administered questionnaire.

RESULTS

According to 81.5% of the PPs, at least two to five TB cases were diagnosed in their clinic per week. The correct anti-tuberculosis treatment regimens recommended by the National Tuberculosis Programme (NTP) were mentioned by only 9.7% of the doctors, while 63% listed 68 regimens. The majority (41.0%) monitored treatment using chest X-ray (CXR) alone, while 21.0% use CXR in combination with another diagnostic tool. Eighty per cent of the PPs did not keep a TB register, and case holding was non-existent.

CONCLUSIONS

PPs in Addis Ababa diagnose a high number of TB cases. However, there is a huge lack of information on anti-tuberculosis treatment. This shows the likely irrational use of the few available anti-tuberculosis drugs, which may favour the emergence and spread of drug resistance.