ABSTRACT
Background: Tuberculosis is a major public health problem throughout the world particularly in resource limited countries. Measuring and reporting of TB treatment outcomes and identifying associated factors are fundamental part of TB treatment. The aim of this study was to assess TB treatment outcome and associated factors among TB patients in Wolayta Sodo Teaching and Referral Hospital, Southern Ethiopia.
Design and Methods: Facility based retrospective cohort study was conducted in Wolayta Sodo Teaching and Referral Hospital. All TB patients who registered during September 2014 to August 2019 and had known treatment outcome were included in the study. The data were collected using pretested structured data extraction format that included demographic, clinical and treatment outcome variables. SPSS Version 23 for windows was used for data processing. Bivariate and multivariate analysis with 95% confidence interval (CI) was employed to infer associations between the independent and dependent variables.
Results: Of total 232 TB patient included in the study, 54.3% were male,80.2% were urban residents, 65.9% were pulmonary TB (PTB). From the total 153 PTB cases,31.5% were smear positive, 17.2% were HIV co-infected and all of them were on antiretroviral treatment. Most, 97.0% of the TB cases were newly diagnosed and all were treated as first line treatment category. The overall treatment success rate was 82.5% (28% cured 54.3% completed), 11.2% loss to follow-up, 4.7% dead and 0.9% treatment failure. The treatment success rate of HIV co-infected TB patients was 77.5%. There was no significant association between TB treatment outcome and age, sex, residence, type of TB, category of patients and HIV status.
Conclusions: The treatment success rate was low (82.5%) which is below the90% threshold defined standard with high proportion of patient’s lost to follow-up (11.2%). A higher number of transfer-out cases were recorded in this study. Thus, supervision and monitoring of DOTs implementation, improved counseling service, mechanisms for lost to follow-up patients should be strengthen. Establish efficient referral and contact tracing mechanisms for transferred-out cases and document their treatment outcomes of status is also fundamental.
REFERENCES
Muluye, A.B., et al., Poor treatment outcomes and its determinants among tuberculosis patients in selected health facilities in East Wollega, Western Ethiopia. PLoS One, 2018. 13(10): p. e0206227.
Organisation, W.H., Global tuberculosis report 2017. 2017, WHO Geneva, Switzerland.
Organization, W.H., Global tuberculosis report 2019. Geneva (Switzerland): World Health Organization; 2019. 2019.
Eshetie, S., et al., Tuberculosis treatment outcomes in Ethiopia from 2003 to 2016, and impact of HIV co-infection and prior drug exposure: A systematic review and meta-analysis. PLoS One, 2018. 13(3): p. e0194675.
Hailu, D., W.E. Abegaz, and M. Belay, Childhood tuberculosis and its treatment outcomes in Addis Ababa: a 5-years retrospective study. BMC Pediatr, 2014. 14: p. 61.
Organization, W.H., WHO guidelines on tuberculosis infection prevention and control: 2019 update. 2019: World Health Organization.
Mekonnen, D., et al., Profile and treatment outcomes of patients with tuberculosis in Northeastern Ethiopia: a cross sectional study. Afr Health Sci, 2016. 16(3): p. 663-70. DOI: https://doi.org/10.4314/ahs.v16i3.4
Worku, S., et al., Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study. Infect Dis Poverty, 2018. 7(1): p. 16. DOI: https://doi.org/10.1186/s40249-018-0395-6
Tesfahuneygn, G., G. Medhin, and M. Legesse, Adherence to Anti-tuberculosis treatment and treatment outcomes among tuberculosis patients in Alamata District, northeast Ethiopia. BMC Res Notes, 2015. 8: p. 503.
Tola, A., et al., Tuberculosis Treatment Outcomes and Associated Factors among TB Patients Attending Public Hospitals in Harar Town, Eastern Ethiopia: A Five-Year Retrospective Study. Tuberc Res Treat, 2019. 2019. DOI: https://doi.org/10.1155/2019/1503219
Muluye, A.B., et al., Poor treatment outcomes and its determinants among tuberculosis patients in selected health facilities in East Wollega, Western Ethiopia. PLoS One, 2018. 13(10). DOI: https://doi.org/10.1371/journal.pone.0206227
Melese, A. and B. Zeleke, Factors associated with poor treatment outcome of tuberculosis in Debre Tabor, northwest Ethiopia. BMC Res Notes, 2018. 11. DOI: https://doi.org/10.1186/s13104-018-3129-8
Seid, M.A., et al., Drug-susceptible tuberculosis treatment success and associated factors in Ethiopia from 2005 to 2017: a systematic review and meta-analysis. BMJ Open, 2018. 8(9). DOI: https://doi.org/10.1136/bmjopen-2018-022111
Eshetie, S., et al., Tuberculosis treatment outcomes in Ethiopia from 2003 to 2016, and impact of HIV co-infection and prior drug exposure: A systematic review and meta-analysis. PLoS One, 2018. 13(3). DOI: https://doi.org/10.1371/journal.pone.0194675
Alene, K.A., et al., Mapping tuberculosis treatment outcomes in Ethiopia. BMC Infect Dis, 2019. 19. DOI: https://doi.org/10.1186/s12879-019-4099-8
Asres, A., D. Jerene, and W. Deressa, Delays to treatment initiation is associated with tuberculosis treatment outcomes among patients on directly observed treatment short course in Southwest Ethiopia: a follow-up study. BMC Pulm Med, 2018. 18(1): p. 64. DOI: https://doi.org/10.1186/s12890-018-0628-2
Mohammed, T., et al., Treatment outcomes of tuberculosis patients in nigist Eleni Mohammed general hospital, hosanna, southern nations, nationalities and peoples region, Ethiopia: a five year (June 2009 to August 2014) retrospective study. Arch Public Health, 2017. 75: p. 16.
Weldegebreal, F., H. Mitiku, and Z. Teklemariam, Treatment outcome of tuberculosis among Human Immunodeficiency Virus positive patients in Eastern Ethiopia: a retrospective study. Pan Afr Med J, 2018. 30. DOI: https://doi.org/10.11604/pamj.2018.30.32.12554
Adane, K., M. Spigt, and G.J. Dinant, Tuberculosis treatment outcome and predictors in northern Ethiopian prisons: a five-year retrospective analysis. BMC Pulm Med, 2018. 18. DOI: https://doi.org/10.1186/s12890-018-0600-1
Wondale, B., et al., A retrospective study on tuberculosis treatment outcomes at Jinka General Hospital, southern Ethiopia. BMC Res Notes, 2017. 10(1): p. 680. DOI: https://doi.org/10.1186/s13104-017-3020-z
Mok, J., et al., Treatment outcomes and factors affecting treatment outcomes of new patients with tuberculosis in Busan, South Korea: a retrospective study of a citywide registry, 2014-2015. BMC Infect Dis, 2018. 18(1): p. 655. DOI: https://doi.org/10.1186/s12879-018-3574-y
Ejeta, E., et al., Factors associated with unsuccessful treatment outcome in tuberculosis patients among refugees and their surrounding communities in Gambella Regional State, Ethiopia. PLoS One, 2018. 13(10). DOI: https://doi.org/10.1371/journal.pone.0205468
Berihun, Y.A., T.M. Nguse, and G.B. Gebretekle, Prevalence of Tuberculosis and Treatment Outcomes of Patients with Tuberculosis among Inmates in Debrebirhan Prison, North Shoa Ethiopia. Ethiop J Health Sci, 2018. 28(3): p. 347-54. DOI: https://doi.org/10.4314/ejhs.v28i3.13
Woldeyohannes, D., et al., Predictors of time to unfavorable treatment outcomes among patients with multidrug resistant tuberculosis in Oromia region, Ethiopia. PLoS One, 2019. 14(10). DOI: https://doi.org/10.1371/journal.pone.0224025
Ketema, D.B., K.F. Muchie, and A.A. Andargie, Time to poor treatment outcome and its predictors among drug-resistant tuberculosis patients on second-line anti-tuberculosis treatment in Amhara region, Ethiopia: retrospective cohort study. BMC Public Health, 2019. 19. DOI: https://doi.org/10.1186/s12889-019-7838-2
Most read articles by the same author(s)
- Melese Yeshambaw Teferi, Simon Genet Woldesenbet, Solomon Asnakew Feleke, Ermias Hundito Abebe, Hawult Taye Adane, Chalachew Misganaw Alemayehu, Assessment of the level and factors associated with knowledge, attitude and practice of blood donation among medical and paramedical personnel in ALERT Hospital, Ethiopia , Journal of Public Health Research: Vol 10 No 1 (2021)