Determinants of tuberculosis treatment outcome under directly observed treatment short courses in Adama City, Ethiopia

Abstract

Background Tuberculosis (TB) is a leading cause of death among infectious agents, ranking above HIV/ AIDS. Though much effort has been done, Ethiopia remained one of those countries which share the greatest burden of TB. Evaluating the TB treatment outcome is one method of TB control measures. Therefore, the aim of the current study was to assess TB treatment outcome and its determinants under directly observed treatment short courses in Adama City, Central Ethiopia. Method An institutional based cross sectional study was conducted in all public and private health facilities of Adama city from March 1 st 2016 to December 31 st , 2016. The data were entered and analyzed by using SPSS version 21.0 statistical software. The results were presented using descriptive statistics. Univariate and multivariate logistic regression model was used to evaluate the potential determinants of unsuccessful treatment outcome. Results Among 281 patients evaluated, 90(32%) were cured, 137(48.8%) have completed the treatment, 4(1.4%) were treatment failure, 36(12.8%) were lost to follow up, and 14 (5%) died. The overall treatment success rate was 80.8%. Age 15-24 (Adjusted odds ratio (AOR): 4.97; 95% Confidence interval (CI): 1.13-21.90), distance less than 5 kilometers from treatment center (AOR: 3.1; 95% CI: 1.42-6.77), being seronegative for human immunodeficiency virus (HIV) (AOR: 20.38; 95% CI: 7.80-53.24) were associated with successful TB treatment outcome. Conclusion The treatment outcome of all forms tuberculosis patients in Adama city was unsatisfactory when referred with the national pooled estimate of 86% and WHO 2030 international target

<p>Tuberculosis Treatment Outcomes and Associated Factors Among Patients Treated at Woldia General Hospital in Northeast Ethiopia: An Institution-Based Cross-Sectional Study</p>

“…4 This discrepancy might be due to the reason that the previous studies conducted among prisoners, MDR tuberculosis patients, and tuberculosis patients at referral hospitals; where complicated cases were treated causing more unsuccessful treatment outcome, whereas the current study was undergone at the general hospital; where less complicated patients were treated which increases the treatment success rate. The result of this study was almost similar to studies done in Adama city (80.8%), 27 West Ethiopia (82.5%), 3 Gonder (79%), 28 and Afar region (81.8%). 13 In this study, a successful tuberculosis treatment outcome was higher among patients treated in 2018 than those who were treated in 2015 and 2016.…”

Treatment Outcomes and Predictors Among Tuberculosis Patients at Madda Walabu University Goba Referral Hospital, Southeast Ethiopia

“…On the contrary, the mortality rate of our study was comparatively close to different studies from other regions in the country with 5% in Adama, 16 5.6% in Debre Tabor, 33 2.9% in Tigray region, 13 1.8% in Arba Minch, 19 3.7% in Addis Ababa, 34 3.9% in Harar 12 and 3.8% in northern Shoa 20 and elsewhere in China (2.8%) 28 and Pakistan (1.8%). 30 However, our study finding is much lower than the mortality rate (19.4%) of the study done in Nigeria.…”

“…The success rate in the current study was in line with the retrospective studies conducted in eastern Ethiopia, Harar with success rate of 92.5%, 12 89.2% in Tigray, 13 overall mean treatment success rate 92.4% in Hawassa, 14 89% in Sidama zone, 15 the Ethiopian national strategic goals (90%) set for 2020 11 and the WHO 2030 international target of ≥90%. 8 The treatment success rate in our study (91.2%) was higher than previous similar studies in Adama (80.8%), 16 retrospective studies in Addis Ababa 82.7%, 17 Hosanna (43.3%), 18 Arba Minch (74.6%), 19 86.1% in Amhara region, northern Shoa, 20 a study from selected hospitals in Ethiopia (55.8%) 21 and the pooled estimate of TB treatment success rate in Ethiopia (86%). 22 The finding in this study is still higher than the finding from other countries with treatment success rate of 57.7% in Nigeria, 23 81% in northern Tanzania, 24 77.4% in Yemen, 25 53.4% in Malaysia 26 and 80.5% in Denmark 27 and a study from China by Bao et al with 88%.…”

“…19 Nonetheless, the rate of treatment failure of the current research is slightly superior to other research findings done in northern (0.3%) 36 parts of Ethiopia, and similar studies from Zambia (0.3%) 37 and Pakistan (0.2%). 30 Ccontrary to this, our treatment failure rate finding is lower than other similar studies, Melese and Ewnete 3.5% 33 and Tesema et al 1.4% 16 in Ethiopia and 8.3% in southern Nigeria. 32 In an attempt to assess predictors of treatment outcomes, being HIV-positive as well as old age had significant association with unsuccessful treatment outcomes.…”

Factors Associated with Unsuccessful Treatment of Tuberculosis in Arsi-Robe Hospital, Arsi Zone, Ethiopia: A Retrospective Study

“…According to Dangisso et al [15], the higher proportion of deaths in PTB-cases than PTB + and EPTB cases might be due to diagnosis and treatment delays, as well as HIV infection among PTB-cases. The recorded higher death in TB patients of older ages might be due to increasing comorbidities as well as the general immunological deterioration with age [35][36].…”