Determinants of Successful Tuberculosis Treatment Outcome in a State University Teaching Hospital in South East, Nigeria: A 5 Year Retrospective Study

Main Article Content

Chinonyelu J. Orji
Onyinye H. Chime
Edmund N. Ossai

Abstract

Aim: The 2018 World Health Organization Global Tuberculosis Report enlisted Nigeria as one of the seven countries worldwide that accounted for 64% of all new cases of tuberculosis. The aim of this study was to assess the magnitude and determinants of tuberculosis treatment outcomes at a Tertiary Hospital in South East, Nigeria.

Study Design: Retrospective cohort.

Place and Duration: The Enugu State University Teaching Hospital Directly Observed Treatment Center, between April 2009 and March 2013.

Methods: Completely filled data were extracted from tuberculosis treatment cards and registers of 445 clients (255 males, 190 females; age range 0-90 years) who assessed care at the DOTS clinic.  Tuberculosis treatment success outcome is defined as cured or completed TB treatment.

Results: Of 445 registered patients, majority was males (57.3%), lived in urban areas (68.1%), and were newly diagnosed (97.8%). Of the 93.7% with pulmonary tuberculosis, 62% were smear negatives cases (62%). While the male to female ratio of the clients was 1.3:1, their mean age was 42 ± 16.7 years. About half (50.6%) had chest x-ray findings that were not diagnostic of Tuberculosis. While TB/HIV co-infection rate was 32.8%; 16% and 19.3% had commenced anti -retroviral and co-trimoxazole preventive treatment respectively. Treatment success was reported in 67.9% of all clients and was associated with being older than 14 year (AOR=12.0, 95% CI: 2.5 – 58.0) and having positive chest findings (AOR = 2.6, 95% CI: 0.3-0.6).

Conclusions: The TB success rate in was 67.9% Being older than 14 years, having PTB and positive chest x ray findings were the predictors of good treatment outcome in this study. There is an urgent need to track and report the treatment outcome of patients who are lost to follow up since they constitute 20% of missed cases in this center.

Keywords:
Tuberculosis, treatment outcomes, Nigeria, tertiary hospital.

Article Details

How to Cite
Orji, C. J., Chime, O. H., & Ossai, E. N. (2019). 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, 39(1), 1-8. https://doi.org/10.9734/ijtdh/2019/v39i130195
Section
Original Research Article

References

United States center for disease control: Nigeria Tuberculosis Factsheet; 2010.
Available:http://www.cdc.gov
(Accessed 15 September 2018)

World Health Organization (Who). Global Tuberculosis Report. World Health Organization, Geneva, Switzerland; 2018.
Available:http://www.who.int>tb>gtb2018_executive_summary
(Accessed 16 September 2018)

Ali MF, Karanja S, Karama M. Factors associated with tuberculosis treatment outcomes among tuberculosis patients attending tuberculosis treatment centers in 2016-2017 in Mogadishu, Somalia. Pan African Medical Journal 2017;28:197.

Inambao A, Adan A, Mohamed A. Report on the evaluation of the global fund TB program in Somalia; 2013.
(Accessed on 4 September 2018)

Kanabus A. Information about tuberculosis: TB statistics-global, regional and high burden. Global Health Education; 2017.
Available:http://www.tbfacts.org
(Accessed on 4 September 2018)

World Health Organization. Tuberculosis Media Centre Facts Sheet N◦104. WHO, Geneva; 2016.
Available:http://www.who.int/mediacenter/factsheets/fs104/en/
(Accessed on 5 September 2018)

World Health Organization. Global Tuberculosis. World Health Organization, Geneva, Switzerland; 2017.
Available:http://www.who.int>tb> gtb2017_executive_summary
(Accessed 16 September 2018)

Duru CB, Uwakwe KA, Nnebue CC, Diwe KC, Merenu IA, Emerole CO, Iwu CA, Duru CA. Tuberculosis treatment outcomes and determinants among patients treated in hospitals in Imo State, Nigeria. Open Access Library Journal. 2016;3(1): e275427-32.
Available:http://dx.doi.org/10.4236/oalib.1102754

Federal Ministry of Health, Nigeria. National Tuberculosis and Leprosy Control Programme Workers Manual. Revised 6th Edition. 2015;1-5.

Igwebueze OI. Clinical audit of quality of intrapartum care in a State University Teaching Hospital, Enugu, Southeast, Nigeria. J. Women’s Health Care. 2015;4: 249.
DOI: 10.4172/2167-0420.1000249

National Population Commission. National Population Census. Federal Republic of Nigeria Official Gazette. 2006;96(2).
Available:https://www.informationng.com (Assessed Online on August 2, 2018)

Banu S, Rahman MT, Uddin MKM. Epidemiology of tuberculosis in an urban slum of Dhaka City, Bangladesh. PLoS One. 2013;8:e77721.

Sitienei J, Nyambati V, Borus P. The epidemiology of smear positive tuberculosis in three TB/HIV high burden provinces of Kenya (2003–2009), Epidemiol. Res. Int. 2013;213:417038.

Rao S. Tuberculosis and patient gender: An analysis and its implications in Tuberculosis Control, Lung India. 2009; 26(1):46–47.

Hoa NB, Wei C, Sokun C. Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China and Vietnam. BMC Public Health II. 2011;367.

Ogbudebe LC, Izuogu S, Abu CE. Magnitude and treatment outcomes of pulmonary tuberculosis patients in a poor urban slum of Abia State, Nigeria. Int. Journal of Mycobacteriology. 2006;5:205-210.

Oyefabi A, Adetiba E, Leeshak E, Adesigbin O. Tuberculosis and the determinants of treatment outcome in Zaira, North Western Nigeria- A nine-year (2007-2015) epidemiological review. J Med Trop. 2017;19:116-22.

Biruk M, Yimam B, Abrha H, Biruk S, Amdie ZF. Treatment outcomes of tuberculosis and associated factors in an Ethiopian University Hospital. Advances in Public Health. 2016;2:1-9.
Available:http://dx.doi.org/10.1155/2016/8504629

Snow K, Hesseling AC, Naidoo P, Graham SM, Denholm J, Preez KD. Tuberculosis in adolescents and young adults: Epidemiology and treatment outcomes in Western Cape. Int. J Tuberculosis and Lung Diseases. 2017;21(6):651-657.
Available:http://dx.doi.org/10.5588/ijtld.16.0866

Fatiregun AA, Ojo AS, Bamgboye AE. Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria. Annals of African Medicine. 2009;8(2):100-104.

Tafess K, Mengistu B, Woldeyohannes D, Sisay S. Determining treatment outcome of smear-positive pulmonary tuberculosis cases in Afar Regional State, Ethiopia: A retrospective facility-based study. Int. Journal of Mycobacteriology. 2016;1:5164-169.

Jasmer RM, Seaman CB, Gonzalez LC, Kawamura LM, Osmond DH, Daley CL. Tuberculosis treatment outcomes directly observed therapy compared with self-administered therapy. Am J Respir Crit Care Med. 2004;170(1):561–566.
Available:http://www.ncbi.nlm.gov/pubmed/1518421

Hotez PJ, Kamath A. Neglected tropical diseases in sub-Saharan Africa: Review of their prevalence, distribution, and disease burden. PLoS Negl Trop Dis.2009;3:e412.

Mhalu FS. Burden of diseases in poor resource countries: Meeting the challenges of combating HIV/AIDS, tuberculosis and malaria. Tanzan J Health Res. 2005;7:179.

Anunnatsiri S, Chetchotisakd P, Wanke C. Factors associated with treatment outcomes in pulmonary tuberculosis in Northeastern Thailand. Southeast Asian Journal of Tropical Medicine and Public Health. 2005;36(2):324–330.

Sanchez M, Bartholomay P, Arakaki-Sanchez D. Outcomes of TB treatment by HIV status in national recording systems in Brazil, 2003–2008. PLoS One. 2012;7(3). Article ID: e33129.

Nik Nor Ronaidi NM, Mohd NS, Wan Mohammad Z, Sharina D, Nik Rosmawati NH. Factors associated with unsuccessful treatment outcome of pulmonary tuberculosis in Kota Bharu, Kelantan. Malaysian Journal of Public Health Medicine. 2011;11(1):6–15.

Nafae RM, Elshahat HM, Said M, Ibrahim MA. Reviewing treatment outcomes of tuberculosis patients at Zagazig Chest Hospital (2008-2012). Egyptian Journal of Chest Diseases and Tuberculosis. 2017;66(4):623-670.

Ahmad T, Haroon, Khan M, Khan MM, Ejeta E, Karami M, Ohia C. Treatment outcome of tuberculosis patients under directly observed treatment short course and its determinants in Shangla, Khyber-Pakhtunkhwa, Pakistan: A retrospective study. Int J Mycobacteriol. 2017;6(4):360-364. Available:https://doi.org/10.4103/ijmy.ijmy_69_17

Leveri T, Lekule I, Mollel E, Lyamuya F, Kilonzo K. Predictors of treatment outcomes among multidrug resistant tuberculosis patients in Tanzania. Tuberculosis Research and Treatment Journal; 2019.
Available:https://doi.org/10.1155/2019/3569018