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

Abstract

BackgroundTuberculosis remains to be a major public health problem among under developed world due to delay in detection and treatment of patients with active TB. In Ethiopia, tuberculosis has been recognized as a major public health problem for more than fifty years.ObjectiveThe main objective of this study was to determine treatment outcomes and associated factors among TB patients attending Nigist Eleni Mohammed General Hospital, Hosanna, SNNPR, Ethiopia.MethodsA five years medical records on treatment outcomes of tuberculosis was reviewed by using a retrospective study design. A total of 768 tuberculosis patients’ cards registered in TB unit register from June 2009 to August 2014 were reviewed. Data was coded, cleaned and entered into a computer data base by using EPI Info version 3.5.3 and then analysed by using Spss version 20.0 Descriptive summary values such as frequency and percentage was used to describe the study variable. Moreover, bivariate and multivariate logistic regression analysis with a confidence level of 95% was performed in order to determine the final predictors of the outcome variable. Association of age, sex, residence, HIV status of the patient and TB type/category was assessed with the TB treatment outcome through bivariate analysis. And residence, TB category and HIV status were found significantly associated with the treatment outcomes in bivariate analysis. Finally, the forward addition model was used for the multivariate analysis, and residence, TB category and HIV status of TB patient were entered into the final model to obtain an adjusted odds ratio (AOR).ResultOut of 768 TB patients who were registered at the hospital during the study period, 249 (32.4%) completed the treatment, 84 (10.9%) cured, 11 (1.4%) defaulted, 397 (51.7%) were transferred out to other health facility, 23 (2.9%) died and 4 (0.5%) failed the treatment regimen. In this study, the overall treatment success of TB was 333 (43.3%) as compared to their counterparts, 435 (56.7%). Patients who presented pulmonary TB + ve were more likely to develop risk of poor treatment outcomes as compared to the patients with extra pulmonary TB and pulmonary TB-ve (AOR = 1.915,95% CI;1.213,3.028). The proportion of TB HIV co-infection was16.4%, and HIV + ve TB patients were more likely to develop risk of poor treatment outcomes as compared to their counterparts (AOR = 0.796, 95% CI;0.512,1.236).ConclusionFrom this study, it was generally observed that the rate of defaulting was very low in the hospital. On the other hand, it was observed that the rate of transfer out of patients from the hospital to other health care facilities was very high during the study period. Furthermore, it was observed that patients who came from urban area were less likely to develop risk of poor treatment outcomes as compared to patients who reside in the rural areas.

Tuberculosis treatment outcome among patients treated in public primary healthcare facility, Addis Ababa, Ethiopia: a retrospective study

“…In addition, completing treatment successfully with respect to unsuccessful treatment outcome, the odds of completing treatment successfully was higher in patients with smear positive pulmonary TB and those tested negative for HIV, compared with their counterparts. In contrary, according to a study done in Nigist Eleni Mohammod General Hospital Hosanna, Ethiopia; those patients having smear-positive Pulmonary TB were more likely to had poor treatment outcomes compared with those patients having extra-pulmonary TB [7]. But, the other studies done in other parts of Ethiopia [15,20] and China [27] reported as there is no significant difference between treatment success rate and type of TB.…”

“…Despite the implementation of DOTS program, different reports across the country have indicated the existence of challenges in improving TB treatment outcomes. The challenges are emanated from differences in treatment-seeking behavior, poor compliance, presence of co-infection, variations in experts' qualification, and presence of drug resistance [7][8][9][10][11][12][13]. Due to these outcome differences, WHO in conjunction with the European Region of the International Union Against Tuberculosis and Lung Disease developed standardized categories to evaluate TB treatment outcomes [11,14].…”

Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data

“…According to Federal Ministry of Health assessment in 2013/2014, DOTS program physical coverage reached 98.4% in hospitals and 79% health centers in the country (9). Nevertheless, different reports across the country have indicated the existence of challenges in treatment outcomes of TB patients despite the implementation of DOTS program (10, 11). Poor treatment-seeking behavior, incomplete treatment or poor compliance, treatment interruption, or default, a phenomenon that contributes to prolonged infectiousness and a higher risk of drug resistance, relapsed TB, and death, are the major challenges in DOTS program especially in resource-limited settings (12).…”

Tuberculosis: an experience at government chest disease hospital

“…In contrast, a study by Mohammed T et al and Gadoev J et al, noted that among the pulmonary TB patients who were registered during the study period, the majority 64.7% and 53% respectively were smear-negative. 7,20 Saroj et al, in 2010 demonstrated 10.41% were found positive for AFB by ZN staining. 21 Ben et al, showed that out of 221 sputum samples, 10.85% samples were positive with Ziehl-Neelsen staining.…”

“…Different studies have found similar results. In the study by Mohammed T et al, 84.8% were having pulmonary TB and 15.2% were having extra pulmonary TB 7. In a study by Pooja et al, (45.6%) had EPTB and at the Tuberculosis Clinic at the All India Institute of Medical Sciences, (AIIMS), New Delhi and the Sri Venkateswara Institute of Medical Sciences (SVIMS), Tirupati , patients with EPTB constituted 53% and 30.4% respectively during the period 1994-2002 8,9.…”