Poor treatment outcomes and its determinants among tuberculosis patients in selected health facilities in East Wollega, Western Ethiopia

Abstract

BackgroundAlthough it is a preventable and treatable disease, tuberculosis remains a major medical and public health problem throughout the world. The control and elimination of tuberculosis is currently challenged by the development and spread of antituberculosis drug resistance. The resistance is often correlated to the absence of properly implemented control measures that lead to poor treatment outcomes. Therefore, the aim of the current study was to assess poor treatment outcomes and its determinants among tuberculosis patients in selected health facilities in East Wollega zone, Western Ethiopia.MethodA five-year retrospective cross-sectional study design was employed. Data were collected from patients’ medical record from January to March 2017. Data were entered and analyzed using SPSS version 20. Descriptive statistics were used to generate and summarize frequencies. Univariate and multivariate logistic regression analysis were used to associate the potential determinants of poor treatment outcomes.ResultsFrom 995 patients with documented treatment outcomes, 58.9% were males with a mean age of 31.9±16.3 years and 58% lived in rural areas. Majorities of cases (95.7%) were newly treated ones. Nearly half of the cases had extrapulmonary tuberculosis and 6.8% were co-infected with HIV. Nearly three-quarter of patients had completed their treatment while 17.2%, 2.9%, 4.8%, 0.4% patients were cured, defaulted, died, and failed, respectively. The overall treatment success rate was 91.9%. Being treated in Anger Gute health center (adjusted odds ratio (AOR): 2.27; 95% confidence interval (CI): 1.18–4.38); male (AOR: 1.81; 95% CI: 1.06–3.10); lived in rural areas (AOR: 1.73; 95% CI: 1.02–2.91); previously treated (AOR: 2.72; 95% CI: 1.16–6.39) and unknown HIV status (AOR: 4.56; 95% CI: 1.98–10.50) were determinants of poor treatment outcomes.ConclusionThe current treatment success rate was exceeded the recommended target. However, special attention and strict follow up is required for tuberculosis patients with high risk of unsuccessful treatment outcomes including male, rural resident, previously treated and unknown in HIV status patients throughout their treatment periods.

Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018

“…24 Over three-fifth of the patients studied were in the age group <40 years, this is similar to other findings among prison inmates with TB in North Shoa, Ethiopia but lower than that found among prison inmates in North West province, South Africa and in the general population in Western Ethiopia. 10,20,25 This could be so because of high mobility, high criminal activities and imprisonment among this age group.…”

“…9 Globally, TB burden among prison inmates is 5-50 times higher than among the general population and is estimated to be the leading cause of death among prison inmates. 10 A case of active Pulmonary TB (PTB) can infect 10-15 persons over the course of a year, this might be higher among prison population due to overcrowding and prolonged close contacts. 11,12 In sub-Saharan African prisons, TB remains one of the fastest growing infectious diseases.…”

Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018

“…This is in contrast to finding among prison inmates in northern Ethiopia where HIV coinfection was not associated with treatment outcomes but similar to that in Ethiopian university hospital. 26,34 This could be attributed to the immune compromised associated with both disease, poor adherence to drugs due to large daily pills intake and the negative drug-to-drug interaction between Anti-TB and Anti-Retroviral drugs.…”

Unknown HIV status and the TB/HIV collaborative control program in Ethiopia: systematic review and meta-analysis

“…The articles were published between 2010 to 2019 and undertaken between 2002 to 2017. Forty-two [21][22][23][24][25][26] of studies used data collected before 2015 and remaining four studies [27,[63][64][65][66] from 2015 to 2017. The sample size of the studies varying from 162 [32] to 272,526 [45].…”

“…In this meta-analysis, eight of the nine regions and one of the two city administrative in Ethiopia represented. Sixteen of the studies were from Amhara region [31-34, 36, 39, 42, 44, 46, 48, 49, 51, 53, 57, 62, 65], eleven from Oromia region [23,25,28,29,41,45,49,50,59,61,66], six from Addis Ababa city [26,27,38,40,54,63] and the rest from other regions. We identified three studies among children [26,38,56], and, three among adults [22,32,49], and the remaining 41 among all age groups ( Table 1).…”