{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T23:33:06Z","timestamp":1768347186632,"version":"3.49.0"},"reference-count":114,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Tuberculosis (TB), despite being a preventable and curable disease, remains a leading infectious cause of death. In Eastern Africa, TB poses a significant public health challenge. This study examined TB incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. This study aims to provide evidence for policy and healthcare stakeholders in Eastern Africa.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>This analysis is part of the Global Burden of Disease (GBD) Study 2021 to estimate TB incidence, prevalence, TB-specific mortality, and DALYs. The GBD study applies several analytical tools and uses data from national health surveys, vital registration systems, WHO reports, and hospital records. The results were presented by age group, sex, location, and year, accounting for 95% uncertainty intervals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>A significant decline was observed in TB burden across East African countries between 1990 and 2021. The age standardized TB incidence rate dropped by 53% (95% UI: 50.7%, 55.1%), from 518.8 per 100,000 in 1990\u2013244 in 2021, while TB prevalence dropped by 29.1% (95% UI: 26.3%, 31.7%), from 38,577.6\u201327,366.1 per 100,000. TB-related deaths fell by 64.6% (95% UI: 55.0%, 71.4%), and TB related DALYs declined by 68.2% (95% UI: 60.3%, 73.6%). Despite these improvements, men consistently experienced higher TB incidence, prevalence, mortality, and DALYs compared to women. Ethiopia showed the highest reductions in terms of TB-related mortality and DALYs compared to countries in the region, with annual reduction rates of 6.0% and 6.6%, respectively. Conversely, Somalia had the highest TB burden in 2021 in terms of incidence, mortality, and DALYs. Mauritius and Seychelles maintained the lowest TB burden, attributed to strong health systems and socio-economic conditions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>A significant decline was observed in TB burden across eastern African countries between 1990 and 2021. However, TB rates remain significantly higher than global and African averages. Therefore, continued investment in health systems and tailored interventions is essential to alleviate the disease burdens, specifically in high-prevalence areas.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0331035","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T17:37:17Z","timestamp":1756834637000},"page":"e0331035","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Burden of tuberculosis in Eastern Africa region from 1990\u20132021: A systematic analysis for the Global Burden of Disease 2021 Study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9740-9042","authenticated-orcid":true,"given":"Leltework","family":"Yismaw","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Temesgen","family":"Zewotir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-5009","authenticated-orcid":true,"given":"Essey Kebede","family":"Muluneh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fentabil","family":"Getnet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerebih","family":"Getinet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Habtamu Abebe","family":"Getahun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taye Abuhay","family":"Zewale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengistie Kassahun","family":"Tariku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anemaw","family":"Asrat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mulusew","family":"Andualem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Awoke","family":"Misganaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"pone.0331035.ref001","volume-title":"Global tuberculosis report 2024","author":"World Health Organization","year":"2024"},{"key":"pone.0331035.ref002","first-page":"129","article-title":"Respiratory tuberculosis.","volume-title":"Innovation, communication and engineering","author":"A Ponnuswamy","year":"2013"},{"key":"pone.0331035.ref003","first-page":"225","article-title":"Tuberculosis: An airborne disease","volume":"5","author":"K Yadav","year":"2017","journal-title":"Global J Microbiol Res"},{"issue":"1","key":"pone.0331035.ref004","first-page":"51","article-title":"A review on tuberculosis in human immunodeficiency virus infection","volume":"4","author":"OK Chinedum","year":"2018","journal-title":"Int J Curr Res Med Sci"},{"key":"pone.0331035.ref005","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/oso\/9780198849711.003.0010","article-title":"Preventable and curable, but still a global problem: Tuberculosis from an evolutionary perspective","author":"CA Roberts","year":"2022","journal-title":"Palaeopathol Evolution Med"},{"key":"pone.0331035.ref006","unstructured":"Mohajan H. Tuberculosis is a fatal disease among some developing countries of the world. 2014."},{"issue":"5","key":"pone.0331035.ref007","article-title":"The Global Burden of Disease Study tuberculosis estimates from the Institute for Health Metrics and Evaluation","volume":"53","author":"HH Kyu","year":"2024","journal-title":"Int J Epidemiol"},{"issue":"1","key":"pone.0331035.ref008","doi-asserted-by":"crossref","DOI":"10.1016\/S2666-5247(22)00359-7","article-title":"WHO\u2019s global tuberculosis report 2022","volume":"4","author":"S Bagcchi","year":"2023","journal-title":"Lancet Microbe"},{"issue":"6","key":"pone.0331035.ref009","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1038\/nrmicro2797","article-title":"Global tuberculosis control: lessons learnt and future prospects","volume":"10","author":"C Lienhardt","year":"2012","journal-title":"Nat Rev Microbiol"},{"key":"pone.0331035.ref010","volume-title":"First WHO global ministerial conference: ending TB in the sustainable development era: a multisectoral response: 16\u201317 November 2017, Moscow, Russian Federation","author":"World Health Organization","year":"2017"},{"issue":"9","key":"pone.0331035.ref011","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.5588\/ijtld.16.0142","article-title":"Ending tuberculosis by 2030: can we do it?","volume":"20","author":"AB Suthar","year":"2016","journal-title":"Int J Tuberc Lung Dis"},{"key":"pone.0331035.ref012","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1128\/9781555819866.ch12","article-title":"Tuberculosis\u2014A world health organization perspective.","volume-title":"Tuberculosis and Nontuberculous Mycobacterial Infections","author":"G Sotgiu","year":"2017"},{"key":"pone.0331035.ref013","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.ijid.2018.09.017","article-title":"The historic and unprecedented United Nations General Assembly High Level Meeting on Tuberculosis (UNGA-HLM-TB)-\u2019United to End TB: An Urgent Global Response to a Global Epidemic\u2019","volume":"75","author":"A Zumla","year":"2018","journal-title":"Int J Infect Dis"},{"issue":"7","key":"pone.0331035.ref014","doi-asserted-by":"crossref","first-page":"723","DOI":"10.5588\/ijtld.17.0835","article-title":"Global tuberculosis targets and milestones set for 2016-2035: definition and rationale","volume":"22","author":"K Floyd","year":"2018","journal-title":"Int J Tuberc Lung Dis"},{"issue":"8","key":"pone.0331035.ref015","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s12098-019-02989-2","article-title":"Tuberculosis Control: WHO Perspective and Guidelines","volume":"86","author":"A Kanchar","year":"2019","journal-title":"Indian J Pediatr"},{"issue":"3","key":"pone.0331035.ref016","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5588\/pha.23.0042","article-title":"The second United Nations high-level meeting on the fight to end TB: action is needed to turn the tide by 2030","volume":"13","author":"L Ditiu","year":"2023","journal-title":"Public Health Action"},{"key":"pone.0331035.ref017","volume-title":"Evidence and research gaps identified during development of policy guidelines for tuberculosis","author":"World Health Organization","year":"2024"},{"key":"pone.0331035.ref018","first-page":"69","article-title":"Essential components of a public health tuberculosis prevention, control, and elimination program: recommendations of the Advisory Council for the Elimination of Tuberculosis and the National Tuberculosis Controllers Association","author":"B Cole","year":"2020","journal-title":"MMWR Recommend Report"},{"issue":"11","key":"pone.0331035.ref019","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1111\/tmi.13485","article-title":"National tuberculosis prevalence surveys in Africa, 2008-2016: an overview of results and lessons learned","volume":"25","author":"African TB Prevalence Survey Group","year":"2020","journal-title":"Trop Med Int Health"},{"issue":"1","key":"pone.0331035.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0087262","article-title":"High tuberculosis prevalence in a South African prison: the need for routine tuberculosis screening","volume":"9","author":"L Telisinghe","year":"2014","journal-title":"PLoS One"},{"key":"pone.0331035.ref021","doi-asserted-by":"crossref","first-page":"100278","DOI":"10.1016\/j.jctube.2021.100278","article-title":"Gaps related to screening and diagnosis of tuberculosis in care cascade in selected health facilities in East Africa countries: A retrospective study","volume":"25","author":"NP Mnyambwa","year":"2021","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"issue":"4","key":"pone.0331035.ref022","doi-asserted-by":"crossref","first-page":"423","DOI":"10.3390\/antibiotics10040423","article-title":"Bibliometric Analysis on Tuberculosis and Tuberculosis-Related Research Trends in Africa: A Decade-Long Study","volume":"10","author":"A Igwaran","year":"2021","journal-title":"Antibiotics (Basel)"},{"issue":"6","key":"pone.0331035.ref023","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1007\/s10461-018-02386-4","article-title":"HIV Prevalence Among Tuberculosis Patients in Sub-Saharan Africa: A Systematic Review and Meta-analysis","volume":"23","author":"YA Gelaw","year":"2019","journal-title":"AIDS Behav"},{"issue":"1","key":"pone.0331035.ref024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1556\/1886.2021.00021","article-title":"Tuberculosis challenges: Resistance, co-infection, diagnosis, and treatment","volume":"12","author":"M Heidary","year":"2022","journal-title":"European J Microbiol Immunol"},{"issue":"1","key":"pone.0331035.ref025","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s12962-023-00485-1","article-title":"Health system productivity in sub-Saharan Africa: tuberculosis control in high burden countries","volume":"21","author":"E-H Atake","year":"2023","journal-title":"Cost Eff Resour Alloc"},{"key":"pone.0331035.ref026","volume-title":"Stop TB policy paper: TB impact measurement: policy and recommendations for how to assess the Epidemiological burden of TB and the impact of TB control","author":"World Health Organization","year":"2009"},{"key":"pone.0331035.ref027","article-title":"World population prospects 2022","author":"U Desa","year":"2022","journal-title":"NYUN Dep Econ Soc Aff Popul Div Httpesa Un Orgunpdwpp"},{"key":"pone.0331035.ref028","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/978-3-031-59511-0_16","article-title":"Development Banking in East Africa: The Case of the East African Development Bank.","volume-title":"Perspectives on Development Banks in Africa: Case Studies and Emerging Practices at the National and Regional Level","author":"J Osoro","year":"2024"},{"key":"pone.0331035.ref029","doi-asserted-by":"crossref","DOI":"10.1596\/40348","volume-title":"Tracking universal health coverage: 2023 global monitoring report","author":"World Health Organization","year":"2023"},{"key":"pone.0331035.ref030","first-page":"100133","article-title":"Urbanisation and rural development in sub-Saharan Africa: A review of pathways and impacts","volume":"6","author":"T Gutu Sakketa","year":"2023","journal-title":"Res Global"},{"key":"pone.0331035.ref031","volume-title":"WHO Global Task Force on TB Impact Measurement: report of a subgroup meeting on methods used by WHO to estimate TB disease burden, 11-12 May 2022","author":"World Health Organization","year":"2022"},{"issue":"10258","key":"pone.0331035.ref032","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"T Vos","year":"2020","journal-title":"Lancet"},{"issue":"10440","key":"pone.0331035.ref033","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","article-title":"Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"M Naghavi","year":"2024","journal-title":"Lancet"},{"issue":"10469","key":"pone.0331035.ref034","doi-asserted-by":"crossref","first-page":"2314","DOI":"10.1016\/S0140-6736(24)01446-6","article-title":"The burden of diseases, injuries, and risk factors by state in the USA, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"404","author":"Collaborators GUBoD","year":"2024","journal-title":"Lancet"},{"issue":"9859","key":"pone.0331035.ref035","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1016\/S0140-6736(12)62174-6","article-title":"The story of GBD 2010: a \u201csuper-human\u201d effort","volume":"380","author":"P Das","year":"2012","journal-title":"Lancet"},{"issue":"3","key":"pone.0331035.ref036","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S1473-3099(17)30703-X","article-title":"The global burden of tuberculosis: results from the Global Burden of Disease Study 2015","volume":"18","author":"GBD Tuberculosis Collaborators","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"10258","key":"pone.0331035.ref037","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"CJ Murray","year":"2020","journal-title":"Lancet"},{"key":"pone.0331035.ref038","volume-title":"Global burden of disease study 2019 (GBD 2019) results","author":"Network GBoDC","year":"2020"},{"issue":"3","key":"pone.0331035.ref039","first-page":"217","article-title":"Interventions to reduce tuberculosis mortality and transmission in low- and middle-income countries","volume":"80","author":"MW Borgdorff","year":"2002","journal-title":"Bull World Health Organ"},{"issue":"9859","key":"pone.0331035.ref040","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/S0140-6736(12)61689-4","article-title":"Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990\u20132010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"CJ Murray","year":"2012","journal-title":"Lancet"},{"issue":"8","key":"pone.0331035.ref041","article-title":"Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000-2021: a systematic analysis from the Global Burden of Disease Study 2021","volume":"10","author":"GBD 2021 Sickle Cell Disease Collaborators","year":"2023","journal-title":"Lancet Haematol"},{"issue":"9859","key":"pone.0331035.ref042","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1016\/S0140-6736(12)61680-8","article-title":"Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010","volume":"380","author":"JA Salomon","year":"2012","journal-title":"Lancet"},{"key":"pone.0331035.ref043","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/978-3-319-46889-1_4","article-title":"The second biggest African country undergoing rapid change: Ethiopia.","volume-title":"Africa\u2019s population: In search of a demographic dividend","author":"A Hailemariam","year":"2017"},{"issue":"6","key":"pone.0331035.ref044","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.4269\/ajtmh.2010.10-0180","article-title":"Using giant African pouched rats to detect tuberculosis in human sputum samples: 2009 findings","volume":"83","author":"A Poling","year":"2010","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pone.0331035.ref045","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1186\/s12879-024-09313-0","article-title":"Increased tuberculosis case detection in Tanzanian children and adults using African giant pouched rats","volume":"24","author":"TB Agizew","year":"2024","journal-title":"BMC Infect Dis"},{"key":"pone.0331035.ref046","article-title":"Global tuberculosis report 2020","volume":"2020","author":"WHO G","year":"2020","journal-title":"Glob Tuberc Rep"},{"key":"pone.0331035.ref047","unstructured":"Rutherford A. Political, economic, and health determinants of tuberculosis incidence. 2016."},{"key":"pone.0331035.ref048","article-title":"Report on the WHO\/TDR consultation on promoting implementation\/operational research in countries receiving grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria: Domaine de Penthes, Geneva, Switzerland 9-10 December 2015.","author":"World Health Organization","year":"2016","journal-title":"Report on the WHO\/TDR consultation on promoting implementation\/operational research in countries receiving grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria: Domaine de Penthes, Geneva, Switzerland 9-10 December 2015"},{"issue":"9","key":"pone.0331035.ref049","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2471\/BLT.08.058453","article-title":"Trends in tuberculosis incidence and their determinants in 134 countries","volume":"87","author":"C Dye","year":"2009","journal-title":"Bull World Health Organ"},{"issue":"2","key":"pone.0331035.ref050","doi-asserted-by":"crossref","first-page":"6570","DOI":"10.4081\/idr.2016.6570","article-title":"Tuberculosis 2015: Burden, Challenges and Strategy for Control and Elimination","volume":"8","author":"M Raviglione","year":"2016","journal-title":"Infect Dis Rep"},{"issue":"1","key":"pone.0331035.ref051","first-page":"18","article-title":"Conflict dynamics in the Horn of Africa: Causes, consequences, and the way forward","volume":"9","author":"AT Birhan","year":"2024","journal-title":"Int J Peace Conflict Stud"},{"issue":"07","key":"pone.0331035.ref052","doi-asserted-by":"crossref","first-page":"120","DOI":"10.47772\/IJRISS.2021.5703","article-title":"Challenging Issues in the Horn of Africa (2016- 2021): The Role of the African Union Commission in Conflict Resolution","volume":"05","author":"MM Kikuvi","year":"2021","journal-title":"Int J Res Innov Soc Sci"},{"issue":"1","key":"pone.0331035.ref053","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13031-023-00568-z","article-title":"The impact of conflict on infectious disease: a systematic literature review","volume":"18","author":"V Marou","year":"2024","journal-title":"Confl Health"},{"issue":"3","key":"pone.0331035.ref054","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-080978","article-title":"Impacts of armed conflicts on tuberculosis burden and treatment outcomes: a systematic review","volume":"14","author":"EA Gebreyohannes","year":"2024","journal-title":"BMJ Open"},{"key":"pone.0331035.ref055","first-page":"25","article-title":"Public health in settings of conflict and political instability.","volume-title":"Manson\u2019s Tropical Diseases E-Book","author":"P Spiegel","year":"2023"},{"key":"pone.0331035.ref056","author":"PP Nhassengo","year":"2024"},{"issue":"9","key":"pone.0331035.ref057","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-045434","article-title":"Effect of food insecurity on mental health of patients with tuberculosis in Southwest Ethiopia: a prospective cohort study","volume":"11","author":"M Soboka","year":"2021","journal-title":"BMJ Open"},{"issue":"12","key":"pone.0331035.ref058","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/j.socscimed.2009.03.041","article-title":"Drivers of tuberculosis epidemics: the role of risk factors and social determinants","volume":"68","author":"K L\u00f6nnroth","year":"2009","journal-title":"Soc Sci Med"},{"issue":"1","key":"pone.0331035.ref059","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1093\/inthealth\/ihw055","article-title":"Dedicated health systems strengthening of the Global Fund to Fight AIDS, Tuberculosis, and Malaria: an analysis of grants","volume":"9","author":"VY Fan","year":"2017","journal-title":"Int Health"},{"key":"pone.0331035.ref060","article-title":"The WHO Global Tuberculosis 2021 Report - not so good news and turning the tide back to End TB","author":"J Chakaya","year":"2022","journal-title":"Int J Infect Dis"},{"key":"pone.0331035.ref061","volume-title":"Global tuberculosis report 2021: supplementary material","author":"World Health Organization","year":"2022"},{"issue":"4","key":"pone.0331035.ref062","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1128\/CMR.00061-05","article-title":"Molecular epidemiology of tuberculosis: current insights","volume":"19","author":"B Mathema","year":"2006","journal-title":"Clin Microbiol Rev"},{"issue":"2","key":"pone.0331035.ref063","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.ccm.2005.02.001","article-title":"The DOTS strategy for controlling the global tuberculosis epidemic","volume":"26","author":"TR Frieden","year":"2005","journal-title":"Clin Chest Med"},{"issue":"9144","key":"pone.0331035.ref064","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1016\/S0140-6736(98)03199-7","article-title":"Prospects for worldwide tuberculosis control under the WHO DOTS strategy. Directly observed short-course therapy","volume":"352","author":"C Dye","year":"1998","journal-title":"Lancet"},{"issue":"1","key":"pone.0331035.ref065","article-title":"Is DOTS an effective strategy for TB control in a developing country?","volume":"9","author":"A Otu","year":"2013","journal-title":"Afr J Respir Med"},{"key":"pone.0331035.ref066","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1100\/2011\/984321","article-title":"Evaluation of task shifting in community-based DOTS program as an effective control strategy for tuberculosis","volume":"11","author":"AP Gabriel","year":"2011","journal-title":"ScientificWorldJournal"},{"issue":"9514","key":"pone.0331035.ref067","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/S0140-6736(06)68392-X","article-title":"WHO\u2019s new Stop TB Strategy","volume":"367","author":"MC Raviglione","year":"2006","journal-title":"Lancet"},{"key":"pone.0331035.ref068","first-page":"71","article-title":"Multidrug and extensively drug-resistant TB (M\/XDR-TB): 2010 global report on surveillance and response.","author":"World Health Organization","year":"2010","journal-title":"Multidrug and extensively drug-resistant TB (M\/XDR-TB): 2010 global report on surveillance and response"},{"issue":"3","key":"pone.0331035.ref069","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0001721","article-title":"Has the DOTS strategy improved case finding or treatment success? An empirical assessment","volume":"3","author":"Z Obermeyer","year":"2008","journal-title":"PLoS One"},{"key":"pone.0331035.ref070","volume-title":"Implementing the WHO Stop TB Strategy: A Handbook for National TB Control Programmes","author":"World Health Organization","year":"2008"},{"key":"pone.0331035.ref071","first-page":"327","article-title":"The new stop TB strategy and the global plan to stop TB, 2006-2015","volume":"85","author":"MC Raviglione","year":"2007","journal-title":"SciELO Public Health"},{"issue":"1","key":"pone.0331035.ref072","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s12879-023-08069-3","article-title":"Implementation of evidence-based multiple focus integrated intensified TB screening to end TB (EXIT-TB) package in East Africa: a qualitative study","volume":"23","author":"K Isangula","year":"2023","journal-title":"BMC Infect Dis"},{"issue":"2","key":"pone.0331035.ref073","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1002464","article-title":"Tuberculosis and HIV co-infection","volume":"8","author":"A Pawlowski","year":"2012","journal-title":"PLoS Pathog"},{"issue":"5","key":"pone.0331035.ref074","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1469-0691.2004.00758.x","article-title":"Tuberculosis in HIV-infected patients: a comprehensive review","volume":"10","author":"L Aaron","year":"2004","journal-title":"Clin Microbiol Infect"},{"issue":"7","key":"pone.0331035.ref075","doi-asserted-by":"crossref","DOI":"10.1101\/cshperspect.a017871","article-title":"Tuberculosis and HIV Coinfection","volume":"5","author":"J Bruchfeld","year":"2015","journal-title":"Cold Spring Harb Perspect Med"},{"issue":"4","key":"pone.0331035.ref076","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.ijtb.2015.11.001","article-title":"WHO\u2019s End TB Strategy: From stopping to ending the global TB epidemic","volume":"62","author":"M Uplekar","year":"2015","journal-title":"Indian J Tuberc"},{"issue":"9979","key":"pone.0331035.ref077","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1016\/S0140-6736(15)60570-0","article-title":"WHO\u2019s new end TB strategy","volume":"385","author":"M Uplekar","year":"2015","journal-title":"Lancet"},{"issue":"3","key":"pone.0331035.ref078","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/trstmh\/trv108","article-title":"The WHO\u2019s new End TB Strategy in the post-2015 era of the Sustainable Development Goals","volume":"110","author":"K L\u00f6nnroth","year":"2016","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pone.0331035.ref079","article-title":"National Academies of Sciences E, Medicine, Globally CoItQoHC: Optimizing the Patient Journey by Leveraging Advances in Health Care.","volume-title":"Crossing the Global Quality Chasm: Improving Health Care Worldwide","year":"2018"},{"issue":"2","key":"pone.0331035.ref080","doi-asserted-by":"crossref","first-page":"28","DOI":"10.54660\/.IJFMR.2024.5.2.28-35","article-title":"Patient-Centered Care Models: A Review of Their Influence on Healthcare Management Practices","volume":"5","author":"OD Balogun","year":"2024","journal-title":"J Front Multidiscip Res"},{"issue":"1","key":"pone.0331035.ref081","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1183\/13993003.00424-2016","article-title":"Digital health for the End TB Strategy: developing priority products and making them work","volume":"48","author":"D Falzon","year":"2016","journal-title":"Eur Respir J"},{"issue":"4","key":"pone.0331035.ref082","doi-asserted-by":"crossref","DOI":"10.2196\/17246","article-title":"Mobile Health Apps for Improvement of Tuberculosis Treatment: Descriptive Review","volume":"8","author":"L Keutzer","year":"2020","journal-title":"JMIR Mhealth Uhealth"},{"issue":"2","key":"pone.0331035.ref083","article-title":"Use of Digital Technology to Enhance Tuberculosis Control: Scoping Review","volume":"22","author":"Y Lee","year":"2020","journal-title":"J Med Internet Res"},{"issue":"6","key":"pone.0331035.ref084","doi-asserted-by":"crossref","first-page":"719","DOI":"10.5588\/ijtld.12.0638","article-title":"Mobile health to improve tuberculosis care and control: a call worth making","volume":"17","author":"CM Denkinger","year":"2013","journal-title":"Int J Tuberc Lung Dis"},{"issue":"1","key":"pone.0331035.ref085","doi-asserted-by":"crossref","first-page":"1701596","DOI":"10.1183\/13993003.01596-2017","article-title":"The impact of digital health technologies on tuberculosis treatment: a systematic review","volume":"51","author":"BK Ngwatu","year":"2018","journal-title":"Eur Respir J"},{"issue":"5","key":"pone.0331035.ref086","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2018-001018","article-title":"Digital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities","volume":"3","author":"R Subbaraman","year":"2018","journal-title":"BMJ Glob Health"},{"key":"pone.0331035.ref087","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1183\/2312508X.10002223","article-title":"The use of digital technologies in adherence to anti-tuberculosis treatment.","volume-title":"Digital Respiratory Healthcare (ERS Monograph)","author":"K Fielding","year":"2023"},{"key":"pone.0331035.ref088","article-title":"Digital Health Interventions to Enhance Tuberculosis Treatment Adherence: Scoping Review","volume":"11","author":"S Lee","year":"2023","journal-title":"JMIR Mhealth Uhealth"},{"issue":"2","key":"pone.0331035.ref089","doi-asserted-by":"crossref","first-page":"219","DOI":"10.9745\/GHSP-D-14-00026","article-title":"Evaluation of community-based interventions to improve TB case detection in a rural district of Tanzania","volume":"2","author":"C Colvin","year":"2014","journal-title":"Glob Health Sci Pract"},{"issue":"7","key":"pone.0331035.ref090","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-062298","article-title":"Effectiveness of women-led community interventions in improving tuberculosis preventive treatment in children: results from a comparative, before-after study in Ethiopia","volume":"12","author":"D Jerene","year":"2022","journal-title":"BMJ Open"},{"issue":"5","key":"pone.0331035.ref091","first-page":"401","article-title":"Community involvement in tuberculosis control: lessons from other health care programmes","volume":"4","author":"M Hadley","year":"2000","journal-title":"Int J Tuberc Lung Dis"},{"issue":"5","key":"pone.0331035.ref092","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(21)00033-5","article-title":"Community-based active case-finding interventions for tuberculosis: a systematic review","volume":"6","author":"RM Burke","year":"2021","journal-title":"Lancet Public Health"},{"issue":"1","key":"pone.0331035.ref093","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/2049-9957-3-27","article-title":"Community based interventions for the prevention and control of tuberculosis","volume":"3","author":"A Arshad","year":"2014","journal-title":"Infect Dis Poverty"},{"key":"pone.0331035.ref094","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s12889-015-1523-x","article-title":"Patient and community experiences of tuberculosis diagnosis and care within a community-based intervention in Ethiopia: a qualitative study","volume":"15","author":"O Tulloch","year":"2015","journal-title":"BMC Public Health"},{"key":"pone.0331035.ref095","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1186\/1475-2875-11-282","article-title":"Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda","volume":"11","author":"JN Kalyango","year":"2012","journal-title":"Malar J"},{"issue":"1","key":"pone.0331035.ref096","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1186\/s12913-018-3786-2","article-title":"Improving TB case notification in northern Uganda: evidence of a quality improvement-guided active case finding intervention","volume":"18","author":"E Karamagi","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"pone.0331035.ref097","article-title":"Multisectoral accountability framework to accelerate progress to end tuberculosis by 2030.","author":"World Health Organization","year":"2019","journal-title":"Multisectoral accountability framework to accelerate progress to end tuberculosis by 2030"},{"issue":"1","key":"pone.0331035.ref098","doi-asserted-by":"crossref","first-page":"2","DOI":"10.24248\/eahrj.v1i1.382","article-title":"Beyond the Numbers: Interpreting WHO\u2019s Global Tuberculosis Report 2016 to Inform TB Policy and Practice in the East African Community","volume":"1","author":"TWENDE consortium","year":"2017","journal-title":"East Afr Health Res J"},{"key":"pone.0331035.ref099","doi-asserted-by":"crossref","first-page":"146","DOI":"10.11604\/pamj.2022.43.146.35557","article-title":"Prospects for tuberculosis elimination in Ethiopia: feasibility, challenges, and opportunities","volume":"43","author":"TB Agizew","year":"2022","journal-title":"Pan Afr Med J"},{"issue":"4","key":"pone.0331035.ref100","doi-asserted-by":"crossref","first-page":"241","DOI":"10.5588\/ijtldopen.25.0168","article-title":"Impact of US funding cuts and stop work orders on TB services and research in South Africa","volume":"2","author":"N Ndjeka","year":"2025","journal-title":"IJTLD Open"},{"key":"pone.0331035.ref101","volume-title":"Global tuberculosis report 2022","author":"World Health Organization","year":"2022"},{"issue":"3","key":"pone.0331035.ref102","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0172748","article-title":"MDR-TB treatment as prevention: The projected population-level impact of expanded treatment for multidrug-resistant tuberculosis","volume":"12","author":"EA Kendall","year":"2017","journal-title":"PLoS One"},{"issue":"9","key":"pone.0331035.ref103","article-title":"The multidrug-resistant tuberculosis threat: old problems and new solutions","volume":"7","author":"G Sotgiu","year":"2015","journal-title":"J Thorac Dis"},{"issue":"1","key":"pone.0331035.ref104","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0147397","article-title":"Psycho-Socio-Economic Issues Challenging Multidrug Resistant Tuberculosis Patients: A Systematic Review","volume":"11","author":"BE Thomas","year":"2016","journal-title":"PLoS One"},{"key":"pone.0331035.ref105","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/B978-0-443-24035-5.00016-5","article-title":"Impact of socioeconomic factors on the treatment of tuberculosis.","volume-title":"Emerging Paradigms in Delivery Systems for Antitubercular Therapy","author":"SC Reddy","year":"2025"},{"key":"pone.0331035.ref106","volume-title":"Socio-Economic and Psychological Burden of MDR-TB Patients at Ballari District-A Cross Sectional Study","author":"B Padmashali","year":"2019"},{"issue":"10024","key":"pone.0331035.ref107","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(15)00151-8","article-title":"Tuberculosis","volume":"387","author":"K Dheda","year":"2016","journal-title":"Lancet"},{"issue":"22","key":"pone.0331035.ref108","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1056\/NEJMra1405427","article-title":"Latent Mycobacterium tuberculosis infection","volume":"372","author":"H Getahun","year":"2015","journal-title":"N Engl J Med"},{"issue":"4","key":"pone.0331035.ref109","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0017601","article-title":"Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review","volume":"6","author":"EW Tiemersma","year":"2011","journal-title":"PLoS One"},{"key":"pone.0331035.ref110","article-title":"Biological differences between the sexes and susceptibility to tuberculosis","author":"S Nhamoyebonde","year":"2014","journal-title":"J Infect Dis"},{"issue":"7","key":"pone.0331035.ref111","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1055\/s-0043-1764231","article-title":"Sex-Related Differences in Patient Characteristics, Risk Factors, and Symptomatology in Older Adults with Pulmonary Embolism: Findings from the SERIOUS-PE Study","volume":"49","author":"B Bikdeli","year":"2023","journal-title":"Semin Thromb Hemost"},{"issue":"4","key":"pone.0331035.ref112","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1001\/archinte.167.4.335","article-title":"Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis","volume":"167","author":"MN Bates","year":"2007","journal-title":"Arch Intern Med"},{"issue":"9","key":"pone.0331035.ref113","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002119","article-title":"Sex Differences in Tuberculosis Burden and Notifications in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis","volume":"13","author":"KC Horton","year":"2016","journal-title":"PLoS Med"},{"issue":"3","key":"pone.0331035.ref114","doi-asserted-by":"crossref","first-page":"524","DOI":"10.2105\/AJPH.2009.175646","article-title":"Mining and risk of tuberculosis in sub-Saharan Africa","volume":"101","author":"D Stuckler","year":"2011","journal-title":"Am J Public Health"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0331035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T17:37:34Z","timestamp":1756834654000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0331035"}},"subtitle":[],"editor":[{"given":"Atalel Fentahun","family":"Awedew","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,2]]},"references-count":114,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0331035","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,2]]}}}