Treatment outcomes of Nigerian patients with tuberculosis: A retrospective 25-year review in a regional medical center

Abstract

Introduction Tuberculosis (TB) remains a global health challenge and leading infectious killer worldwide. The need for continuous evaluation of TB treatment outcomes becomes more imperative in the midst of a global economic meltdown substantially impacting resource-limited-settings. Methods This study retrospectively reviewed 25-years of treatment outcomes in 3,384 patients who were managed for TB at a tertiary hospital in Nigeria. Confirmed TB cases were given directly observed therapy of a short-course treatment regimen and monitored for clinical response. Results Out of 1,146,560 patients screened, there were 24,330 (2.1%) presumptive and 3,384 (13.9%) confirmed TB cases. The patients’ mean age was 35.8 years (0.33–101 years). There were 1,902 (56.2%) male, 332(9.8%) pediatric, and 2,878 (85%) pulmonary TB cases. The annual mean measured treatment outcomes were as follows: adherence, 91.4(±5.8) %; successful outcome, 75.3(±8.8) % potentially unsatisfactory outcome, 14.8(±7.2) %; and mortality 10.0(±3.6) %. Female, extra-pulmonary TB (EPTB), newly diagnosed, and relapsed patients compliant with treatment had successful outcomes. Adulthood and HIV infection were mortality risk factors. Conclusion The mean annual successful treatment outcome is 75.3(±8.8) %. Female, pediatric, EPTB, new, and relapsed patients were predisposed to successful treatment outcomes. Lessons learned will guide future program modifications.

Trends in rifampicin resistance among patients with presumptive TB in the pre-COVID and COVID-era

“…These type of measure may have ameliorated the impact of the disruption in health services occasioned by the COVID-19 pandemic and attendant reversal of gains in control of diseases of public important like TB. The large sample size, which spans around 7 years in a well-established TB control programme [25] ., distinguishes this study from lower middle-income country viewpoints. The use of Xpert MTB/RIF, which has a rapid turnaround time and outstanding sensitivity, lends credence to this work.…”

Knowledge about tuberculosis, treatment adherence and outcome among ambulatory patients with drug-sensitive tuberculosis in two directly-observed treatment centres in Southwest Nigeria

“…The WHO and NTBLCP have also advocated that further strengthening and decentralization of TB services may be a way forward to achieve the WHO End TB strategy [48,49]. In Nigeria, the major drawback to the TB-DOT decentralization advocacy, may be the lack of competent healthcare personnel at the peripheral facilities to deliver the DOT services [19,33,48]. Thus, government and other concerned stakeholders may need to step-up their political and financial commitments toward TB treatment and care, in order to achieve the third united nation sustainable development goals and the WHO End TB strategy of eradicating TB globally by the year 2030 target [1,50].…”

“…The questionnaire and data collection form were designed by the investigators following extensive review of relevant studies [30][31][32][33][34][35][36][37], as well as previous practice experience. The prospective cross-sectional survey consisted of 25-item questions, including open-ended, closed-ended and open-ended questions with relevant prompts.…”

“…Though, there are studies from many developed and some developing countries that had evaluated knowledge, attitude and practice about TB, as well as barriers to TB treatment adherence [30][31][32][33][34][35]. However, most of these studies still left gaps that underscore the necessity for continuous monitoring and evaluation of patientspecific reasons for TB treatment non-adherence, while making consistent efforts to evaluate the knowledge deficits of patients about TB may be essential in finding appropriate solution to the low TB treatment success rate.…”

Challenges to paediatric tuberculosis care as perceived by health workers in Kano, North-western Nigeria

“…Poor TB health knowledge has been observed to significantly promote delay in health seeking and nonadherence to TB treatment ultimately negatively impacting TB control in Ethiopia, South Africa and Nigeria, while on the other hand good TB health knowledge of patients promoted good health seeking behaviour also in Ethiopia. [18][19][20][21] Perceived stigma by patients from health workers discourages health seeking, facilitating further spread of TB within communities as observed by Duko et al, who reported a patient perceived stigma prevalence of 42.4% in Ethiopia. 18 The reported Ethiopian perceived stigma prevalence is similar to the reported stigma prevalence in southern Thailand (41.5%) and much lower than the stigma prevalence of Nepal (63.3%).…”