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Category: Volume 10 Issue 10 October 2022
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Title: Trends and Determinants of Tuberculosis Treatment Outcome of Patients on Directly Observed Treatment in a University Teaching Hospital, South-South, Nigeria: A Five-Year Retrospective Study

Authors: Ihekwaba Olubunmi D., Ojule Inumanye N

 DOI: https://dx.doi.org/10.18535/jmscr/v10i10.26

Abstract

Background: Tuberculosis (TB) a leading cause of death from a single infectious agent, continues to constitute a serious public health challenge in both developed and developing countries. Despite the implementation of the DOTS plan and the subsequent adoption of the End TB strategy, Nigeria continues to fall short of WHO targets especially TB treatment success rate (TSR).

Aim: This study aimed at identifying the trend of TB treatment outcomes and its determinants among patients on TB treatment at the University of Port Harcourt Teaching Hospital Directly Observed Therapy Short-Course (UPTH DOTS) Clinic.

Materials and Method: It was a cross sectional study. Data was collected retrospectively. Information was obtained from the medical records and TB registers at the facility's DOTS clinic covering a five-year period (2016-2020). All patients that were registered in the program whether transferred out or retained were included. The data was retrieved and analysed as needed.

Results: The cumulative results revealed that majority of the subjects were mainly new patients (93.0%), Pulmonary TB (85.2%), and HIV negative patients (65.1%), while the result of the treatment success rate was 61.1% (35.5% cured and 25.6% completed treatment), with treatment failure (0.7%), Lost To Follow Up (LTFU) (16.1%), death (13.4%), transfer out (5.0%), and 3.9% not assessed. However, younger age, being female, employed, having tuberculosis of the lungs (PTB) and being HIV negative were identified as contributors to good treatment outcomes.

Conclusion: The trend in the TB treatment outcome over the 5-year period under review showed that treatment success was highest in 2016 (71.3%) and had a major dip in 2020 (52.1%). This low TSR in 2020 cannot be unconnected with the Corona Virus pandemic which disrupted health and healthcare world-wide that year. Also, the result revealed that younger age, female sex, being employed, PTB, and negative HIV status were the major determinants of favourable TB treatment outcome.

Keywords: Tuberculosis, Treatment outcome, Determinant, DOTS centre, Port Harcourt.

References

  1. WKapur, T.S. Whittam, J.M. Musser Is Mycobacterium tuberculosis 15,000 years old? J Infect Dis, 170 (1994), pp. 1348-1349
  2. Daniel TM. The history of Tubercuosis. Respiratory Medicine. volume 100, Issue 11, November 2006, Pages 1862-1870.
  3. Uplekar M, Raviglione M. WHO's End TB Strategy: From stopping to ending the global TB epidemic. Indian Journal of Tuberculosis. 2015 Oct 1;62(4):196-9.
  4. World Health Organisation. Global tuberculosis report, 2020; WHO: Geneva, Switzerland. https://www.who.int/news-room/fact-sheets/detail/tuberculosis/2020.
  5. World Health Organization, Global Tuberculosis Report 2019. WHO: Geneva, 2019. Available at: https://apps.who.int/iris/bitstream/handle/10665/329368/9789241565714-eng.pdf?ua=1.
  6. Zuniga JA. An integrated review of directly observed therapy for Tubercuosis in Latin America. Hisp HealthCare Int. 201513; (1):46-54.
  7. World Health Organization, Fact Sheet : Tuberculosis. 14 october 2021. WHO: Geneva.
  8. Efegbere HA, Anyabolu AE, Onyeyili AN, Efegbere EK, Sani-Gwarzo N et al. Determinants of treatment Outcome of Public-Private MIX Tuberculosis Control Programme. Afrimedic Journal. 2014; vol 5 No 1
  9. Ogbonna VI, Alabere DI, Tobin-West CI. Treatment Outcomes and Associated Factors of Tuberculosis Patients on Directly Observed Treatment in a Tertiary hospital in Port Harcourt, Nigeria. Nigeria Journal a of Medicine. 2020; vol 29 No 4
  10. PefuraYone EW, Kengne AP, & Kuaban C. Incidence, time and determinants of tuberculosis treatment default in Yaounde, Cameroon: a retrospective hospital register-based cohort study. BMJ Open, 2011;1:e000289.
  11. Orji CJ, Chime OH, &Ossai EN. Determinants of Successful Tuberculosis Treatment Outcome in a State University Teaching Hospital in South East, Nigeria: A 5 Year Retrospective Study. International Journal of tropical disease & Health, 2019;39(1):1–8
  12. World Health Organization, Global Tuberculosis Report 2019. WHO: Geneva, 2019. Available at: https://apps.who.int/iris/bitstream/handle/10665/329368/9789241565714-eng.pdf?ua=1
  13. 13Tweya H, Feldacker C, & Phiri S. Comparison of treatment outcomes of new smear-positive pulmonary tuberculosis patients by HIV and antiretroviral status in a TB/HIV clinic, Malawi. PLoS ONE, 2013
  14. Hamusse SD, Demissie M, & Teshome D. Fifteen-year trendin treatment outcomes among patients with pulmonary smear-positive tuberculosis and its determinants in Arsi Zone, central Ethiopia. Global Health Action, 2014;7:25382.
  15. Olarewaju S, Olanrewaju O, Folorunso E, Babatunde A, Temitayo-Oboh A, Abdulsalam S, & Oluwatoyin A. Treatment Outcome of Tuberculosis Patients Registered at DOTS Centre in Ogbomoso, Southwestern Nigeria: A 4-Year Retrospective Study. Tuberculosis Research and Treatment, 2014;201705. Doi: http://dx.doi.org/10.1155/2014/201705
  16. Zenebea T, & Tefera E. Tuberculosis treatment outcome and associated factors among smear-positive pulmonary tuberculosis patients in Afar, Eastern Ethiopia: a retrospective study. The Brazilian Journal of Infectious Diseases, 2016;20(6):635–636
  17. Duru CB, Uwakwe KA, Nnebue CC, Diwe KC, Merenu IA, &Emerole CO. Tuberculosis treatment outcomes and determinants among patients treatedin hospitals in Imo State, Nigeria. Open Access Libr J.,2016;3:e2754
  18. Tessema B, & Muche A. Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia. A five-year retrospective study. BMC Public Health, 2009;9:371–378.
  19. Biadglegne F, Anagaw B, Debebe T, Anagaw B, Tesfaye W, Tessema B, Rodloff AC,& Sack U. A retrospective study on the outcomes of tuberculosis treatment in FelegeHiwot Referral Hospital, Northwest Ethiopia. International Journal of Medicine and Medical Sciences, 2013;5(2):85–91
  20. Umeokonkwo CD, Okedo-Alexa IN, Azuogu BN, Utulua R, Adeke AS, & Disu YO. Trend and determinants of tuberculosis treatment outcome in a tertiary hospital in Southeast Nigeria. Journal of Infection and Public Health, 2019;13:1029–1033
  21. WHO Goal.
  22. Moges B, Amare B, Yismaw G, Workineh M, Alemu S, Mekonnen D, Diro E, Tesema B, & Kassu A. Prevalence of tuberculosis and treatment outcome among university students in Northwest Ethiopia: a retrospective study. BMC Public Health, 2015;15: DOI: 10.1186/s12889-015-1378-1
  23. Worede DT, &Abitew GB. Treatment Outcomes of Patients with Tuberculosis in Districts of Buriezuria, Jabitehinan and Fenoteselam administrative town health facilities, North West Ethiopia. Diversity and Equality in Health and Care, 2021;18(3):270–277
  24. Mengistu E, Feleke M, Yeshambel B, Eleni W, Ahmed E, & Chandrashekhar U. Treatment Outcome of Tuberculosis Patients at Enfraz Health Center, Northwest Ethiopia: A Five-Year Retrospective Study. Tuberculosis Research and Treatment, 2014:726193. Doi: http://dx.doi.org/10.1155/2014/726193
  25. Karo B, Hauer B, Hollo V, van der Werf MJ, Fiebig L, & Haas W. Tuberculosis treatment outcome in the European Union and European Economic Area: an analysis of surveillance data from 2002-2011. Euro Surveill., 2015;20(49):30087
  26. Ibrahim LM, Oleribe OO, Nguku P, Tongwong GC, Mato LG, &Longkyer MI. Evaluation of quality of TB control services by private health care providers in Plateau state, Nigeria. Pan Afr Med J., 2014;17:77. Doi: 10.11604/pamj.2014.17.77.3412.
  27. Oyefabi A, Adetiba E, Leeshak E, &AdesigbinO.. Tuberculosis and the determinants of treatment outcome in Zaria, North Western Nigeria — a nine-year (2007–2015) epidemiological review. J Med Trop., 2017:19:116–122.
  28. Babatunde OI, Christiandolus EO, Bismarck EC, Emmanuel OI, Chike AC, & Gabriel EI. Five years retrospective cohort analysis of treatment outcomes of TB-HIV patients at a PEPFAR/DOTS Centre in South Eastern Nigeria. Afri Health Sci, 2016;16(3):655–662.

Corresponding Author

Ojule Inumanye N.

Department of Preventive and Social Medicine, University of Port Harcourt, Port Harcourt, Nigeria