title: Reflections on tuberculosis diagnosis and treatment outcomes in Ghana.
abstract: BACKGROUND
  Available evidence in Ghana shows the implementation of tuberculosis (TB) control activities efforts since the beginning of the 1900s. In spite of that, TB continues to be one of the common diseases in the country. In 1994, local and international policy windows opened for renewed strategies for the control of TB. This paper explores some of the approaches which have been in place since 1994 and their implications for treatment outcomes.
  
  
  METHODS
  The study combines quantitative and qualitative data. The quantitative data consist of treatment outcome from 1997-2010 and the qualitative data are derived from in-depth interviews with some staff of the TB control programme. Poisson regression and inductive coding were applied to the quantitative and qualitative data respectively.
  
  
  RESULTS
  Reported cure rates increased from 43.6% to 87.7% between 1997 and 2010. The data from the in-depth interviews (IDIs) suggested that improvements in diagnosis, community TB care, stigma reduction among community and health workers towards TB patients, the public-private partnership, and the enablers' package contributed to the improved better treatment outcomes, particularly from 2008.
  
  
  CONCLUSIONS
  Lessons learnt include the achievement of objectives with varying strategies and stakeholder interventions. Further studies would be needed to quantify the contributions of the various interventions to help determine those that are cost effective as well as efficient and effective for TB control.
authors: Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. kjamoadjei@yahoo.com.
authors: Joshua
authors: J
authors: Amo-Adjei
authors: Kofi
authors: K
authors: Awusabo-Asare
references: Cah Sociol Demogr Med. 2005 Jan-Mar;45(1):135-61
references: 15938446
references: Am J Public Health. 1993 May;83(5):766-8
references: 8484468
references: Health Policy. 2010 Dec;98(2-3):195-202
references: 20637520
references: BMC Pulm Med. 2009 May 08;9:16
references: 19426477
references: J Pak Med Assoc. 2009 Feb;59(2):82-6
references: 19260569
references: Arch Intern Med. 2003 May 12;163(9):1009-21
references: 12742798
references: Int J Tuberc Lung Dis. 2009 Jun;13(6):698-704
references: 19460244
references: Int J Nurs Stud. 2009 Mar;46(3):302-9
references: 18995854
references: Bull World Health Organ. 2001;79(1):61-8
references: 11217670
references: J Hist Med Allied Sci. 1990 Jul;45(3):366-96
references: 2212609
references: Lancet Infect Dis. 2012 Aug;12(8):608-16
references: 22704778
references: Am J Public Health. 1998 Jul;88(7):1105-17
references: 9663166
references: Patient. 2010 Sep 1;3(3):159-72
references: 22273395
references: BMC Public Health. 2008 Jan 11;8:11
references: 18186946
references: Am J Public Health. 2006 Apr;96(4):685-90
references: 16507738
references: Reprod Health Matters. 2011 Nov;19(38):163-75
references: 22118150
references: Lancet. 2010 Jun 19;375(9732):2169-78
references: 20488514
references: BMJ. 2006 Mar 11;332(7541):574-8
references: 16467347
references: BMC Health Serv Res. 2010 May 07;10:113
references: 20459665
references: Rev Infect Dis. 1989 Mar-Apr;11 Suppl 2:S339-46
references: 2652250
references: Infect Dis Poverty. 2013 May 02;2(1):9
references: 23849141
references: Lancet Infect Dis. 2013 Jun;13(6):529-39
references: 23531391
references: JAMA. 2011 Apr 13;305(14):1415-23
references: 21486974
references: BMJ. 2006 Jan 14;332(7533):85-7
references: 16339219
references: Int J Tuberc Lung Dis. 2009 Aug;13(8):1029-37
references: 19723385