Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study

Gebrezgabiher, Gebremedhin; Romha, Gebremedhin; Ejeta, Eyasu; Asebe, Getahun; Zemene, Endalew; Ameni, Gobena

doi:10.1371/journal.pone.0150560

Cited by 109 publications

(181 citation statements)

References 11 publications

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“…Assessing TB treatment outcomes is important for stakeholders working to evaluate the performance of TB treatment strategies such as DOTS and patientrelated factors. Our present and previous studies [13,14], and other similar studies [6,15] conducted in Ethiopia, consistently show that TB presence is relatively higher among males than females. So far, the reports of consistently high prevalence rates of TB among the male population were discussed poorly in Ethiopia.…”

Section: Discussionsupporting

confidence: 90%

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

et al. 2018

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Background: Data regarding tuberculosis (TB) treatment outcomes, proportion of TB/HIV co-infection and associated factors have been released at different TB treatment facilities in Ethiopia and elsewhere in the world as part of the auditing and surveillance service. However, these data are missing for the TB clinic offering directly observed treatment short-course (DOTs) at Debre Tabor General Hospital (DTGH). Methods: The authors analysed the records of 985 TB patients registered at the DTGH from September 2008 to December 2016. Data on patients' sex, age, type of TB, and treatment outcomes were extracted from the TB treatment registration logbook. The treatment outcome of patients was categorized according to the National TB and Leprosy Control Program guidelines: cured, treatment completed, treatment failed, died, and not evaluated (transferred out and unknown cases). Results: Around half of the registered patients were males (516, 52.4%). In terms of TB types, 381 (38.7%), 241 (24.5%), and 363 (36.9%) patients had smear-negative pulmonary TB, smear-positive pulmonary TB, and extra pulmonary TB, respectively. Six hundred and seventy-two patients (90.1%) had successful treatment outcomes (cured and treatment completed), while 74 patients (9.9%) had unsuccessful treatment outcomes (death and treatment failure).TB treatment outcome was not associated with age, sex, type and history of TB, or co-infection with HIV (P > 0.05). The proportion of TB/HIV co-infection was at 24.2%, and these were found to be significantly associated with the age groups of 25-34, 35-44 and ≥65 years:(aOR: 0.44; 95% CI: 0.25-0.8), (aOR: 0.39; 95% CI: 0.20-0.70), (aOR: 4.2; 95% CI: 1.30-12.9), respectively. Conclusions: The proportion of patients with successful treatment outcomes was above the World Health Organization target set for Millennium Development Goal of 85% and in line with that of the global milestone target set at > 90% for 2025. Relatively higher proportions of transfer-out cases were recorded in the present study. Similarly, the proportion of TB/HIV co-infection cases was much higher than the national average of 8%.Thus, the health facility under study should develop strategies to record the final treatment outcome of transfer-out cases. In addition, strategies to reduce the burden of TB/HIV co-infection should be strengthened.

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Section: Discussionsupporting

confidence: 90%

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

et al. 2018

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“…However the unsuccessful treatment outcome of this study is higher than studies from Southern Ethiopia at Dilla University Referral Hospital [24] and Tigray [15] which reported 14.8% and 10.8% of unsuccessful treatment outcome respectively. This could be due to difference in sample size and study settings.…”

Section: Discussioncontrasting

confidence: 86%

“…This study did not show differences in treatment outcome for gender and residence, however a study done in southern region [23] showed that being male is associated with poor treatment outcome, this might be due to males are highly exposed to cigarette smoking alcohol consumption, which might contribute to poor treatment outcomes and a study done in Dilla university referral hospital [24] showed that being from rural area was associated with poor treatment outcome this might be due to low DOTS performance, inadequate health seeking behavior and lower patient awareness about TB treatment. The reason for the differences could be due to difference in sample size and study settings.…”

Section: Discussionmentioning

confidence: 58%

Factors Affecting Treatment Outcome of Tuberculosis among Tuberculosis Patients in West Ethiopia

Kassa¹,

Dedefo²,

Korsa³

et al. 2018

J Bioanal Biomed

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Background: Tuberculosis is a life threatening disease caused by mycobacterium tuberculosis. In developing countries the incidence of tuberculosis has been increasing steadily since the 1990s, particularly in African countries. Several European countries have lately reported a slight increase in tuberculosis, but these are mostly related to immigrants from high-incidence countries.Objective: To assess the treatment outcomes of tuberculosis and its associated factors among tuberculosis patients on anti-tuberculosis therapy in Nekemte Referral Hospital, West Ethiopia. Methods:A four years retrospective cross-sectional study was used and all patients' information that fulfilled the inclusion criteria was retrieved from records of patients with basic information for all registered patients. We analyzed the records of 315 tuberculosis patients who had known outcome in Nekemte Referral Hospital from September 2012-August 2016.Results: From the total of 315 patients who had known treatment out come in Nekemte Referral Hospital, tuberculosis type was categorized as smear positive pulmonary TB in 68(21.5%), smear negative pulmonary TB in 107(34.0%), and extra pulmonary in 140(44.4%) cases. Records of the 315 TB patients showed that 54(17.01%) were cured, 206(65.4%) completed treatment, 24(3.5%) had treatment failure, 11(3.5%) defaulted, 20(6.3%) were died. The overall treatment success rate of the TB patients was 82.5%. Age ≥ 45 years (AOR=7.1, 95% CI=1.5-34.3, p=0.014), smear negative PTB (AOR=3.4, 95%, CI=1.5-9.5, P=0.023) and retreatment cases (AOR=12.0, 95%, CI=4.2-34.4, P<0.001) were significantly associated with unsuccessful treatment outcome. Conclusion:Successful treatment outcome of TB patients was below standard. To improve treatment outcome among TB patients health education on the importance of TB treatment and the consequences of poorly treated TB have to be provided to patients during their follow up.

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“…[15][16][17] In our study, initial default has found to be significantly associated with the disease whereas initial treatment from a private practitioner has emerged as an independent risk factor for the emergence of drug resistant tuberculosis further reiterating the need for strengthening early diagnosis and treatment aspect of the disease involving private practitioners which at many times are the first point of contact for the patient, so that the looming epidemic of drug resistance is contained.…”

Section: Controls Casementioning

confidence: 78%

Correlates of multi-drug resistant tuberculosis: a case control study from a hilly district of North India

Mazta

Singh

Lal

2017

Int J Community Med Public Health

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Background: Drug resistance has emerged as a major threat to global TB control efforts in recent years. India, with the highest burden of Tuberculosis worldwide, faces a looming epidemic of drug resistant TB due to initial irrational, irregular and incomplete treatment outside the purview of the robust national programme. Himachal Pradesh, a north Indian hilly state with a population of about 7 million has a considerable burden of Tuberculosis with geographical challenges. The present study envisaged to identify the potential risk factors to the emergence of drug resistance TB in the settings of district Shimla.Methods: A pilot case control study, all patients (n=11) enrolled for MDR-TB in Tuberculosis Unit Shimla during the period (2013-14) were included. 3 of who died were excluded. Thrice the number of controls (n=24) were selected after matching for age, sex and approximate geographical location.Results: The univariate analysis showed that, compared with controls, risk factors significantly associated with primary MDR-TB were Socioeconomic status lower than class 3 (OR=13.8; p=0.02), poor ventilation (OR=5; p=0.05), absent BCG scar (OR=23; p=0.002), history of default (p=0.002) and initial treatment from a private practitioner (OR=6.60; p=0.04). The Multivariate analysis showed that the risk factors independently associated with primary MDR-TB were absent BCG scar (OR=28.15; 95% CI=1.51524.38) and initial irrational and incomplete treatment from a private practitioner (OR=16.77; 95% CI =1.12-319.26).Conclusions: In our stud, poor ventilation, lower socioeconomic condition and initial default have been found to be significantly associated with the disease whereas absent BCG scar and initial irrational treatment from private practitioners have emerged as independent risk factors for the emergence of drug resistant Tuberculosis further reiterating the need for strengthening Immunization and early diagnosis and treatment aspect of the disease involving private practitioners. Larger and extensive studies on these aspects are further warranted.

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Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study

Cited by 109 publications

References 11 publications

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

Factors Affecting Treatment Outcome of Tuberculosis among Tuberculosis Patients in West Ethiopia

Correlates of multi-drug resistant tuberculosis: a case control study from a hilly district of North India

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