Trend and determinants of tuberculosis treatment outcome in a tertiary hospital in Southeast Nigeria

Umeokonkwo, Chukwuma David; Okedo‐Alex, Ijeoma Nkem; Azuogu, Benedict Ndubueze; Utulu, Rowland; Adeke, Azuka Stephen; Disu, Yahya Oyewoga

doi:10.1016/j.jiph.2019.10.012

Cited by 13 publications

(28 citation statements)

References 15 publications

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“…In a previous study, male gender was not identified as a risk factor for treatment failure, which may be due to insufficient sample size [21] . The present study showed that the risk of treatment failure significantly increased with increasing patients' age, which is consistent with the findings of other studies [13,[16][17]22] , indicating that younger patients had a higher rate of treatment success. This could be attributed to the weakened immune system in the elderly, the cumulative effects of tobacco consumption, or air pollution, which were not addressed in this study.…”

Section: Discussionsupporting

confidence: 93%

“…Almost similar results have been reported in other studies conducted in different parts of the world, including Turkey (0.3%) [12] , China (0.5%) [13] , Ethiopia (1.2 and 3.5%) [3,14] , and Netherland (2.6%) [15] . Most patients in this study were male, which is compatible with other studies conducted worldwide [16][17][18] , this could be due to the fact that men are more likely to be infected in the community and use health facilities than women. The present study findings showed that treatment failrure is 50% more likely to occur in men than in women, and that male gender is an important predictor of treatment failure, which is in agreement with other studies results [19][20] .…”

Section: Discussionsupporting

confidence: 90%

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Risk Factors of Tuberculosis Treatment Failure among Tuberculosis Patients in Khuzestan Province: A Retrospective Cohort Study

Mousavi

Fararouei

Rashidi

et al. 2021

IEM

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Background: Tuberculosis (TB) is an infectious and communicable disease and one of the top ten causes of death throughout the world. Monitoring and evaluating TB treatment outcomes provides the required data for taking the necessary measures to control TB. Thus, this study was carried out to find determinants of treatment failure among patients with smear-positive pulmonary TB in Khuzestan province during 2006-2014 Material and Methods: This retrospective cohort study was conducted over a 9-year period in Khuzestan province. Predictors of treatment failure were analyzed using multivariate logistic regression Findings: Among 5342 patients, the cumulative incidence of unsuccessful TB treatment was 1.85%. More than half of TB patients (59.2%) enrolled in this study were male, and most of them were living in urban areas (79.8%). Significant predictors of treatment failure were age (p=•001), weight (p= •039), number of delayed days in diagnosis (p=•01), isoniazid resistance (p≤•001), and number of bacilli in patients` sputum at the beginning of treatment (p≤•001). Conclusion:In this study, the rate of successful treatment was quite high; nevertheless, new cases of treatment failure could be prevented with special efforts such as prompt diagnosis and precise follow-up under Direct Observation Treatment Short course (DOTS) strategy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Risk Factors of Tuberculosis Treatment Failure among Tuberculosis Patients in Khuzestan Province: A Retrospective Cohort Study

Mousavi

Fararouei

Rashidi

et al. 2021

IEM

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“…Patients who understood the consequences of their condition, had proper knowledge of the disease and understood the benefits of treatment are mostly likely to adhere to treatment regimens to derived maximum benefits from medications. Several studies have reported varying tuberculosis treatment successes all of which fall short of WHO definition of success [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Humanistic Outcomes of Tuberculosis Treatment in a Nigerian Directly Observed Treatment Short Course Centre

Dayom

Madison

Adeniyi

et al. 2020

JPRI

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Background: Tuberculosis remains a major global health problem. It causes ill-health among millions of people each year and ranks alongside the human immunodeficiency virus (HIV) as a leading cause of death worldwide. The objective of the study was to evaluate the clinical and humanistic outcomes of tuberculosis treatment at the directly observed treatment short-course (DOTS) centre in Jos University Teaching Hospital. Methods: Data for clinical outcomes was collected retrospectively at the directly observed treatment shortcouse centre of Jos University Teaching Hospital from a cross-section of patients’ folders who had been treated for tuberculosis at the study site for at least 12months as at 1st April to 30th September 2018 while a validated questionnaire was administered prospectively to a census population of tuberculosis patients still undergoing treatment between 1st October 2018 and 31st March 2019 to determine the humanistic outcomes. A descriptive data analysis was done using SPSS version 23 and proportions were tested using chi squared statistics with significance level set at P<0.05. Results: The study revealed that tuberculosis treatment success in the centre was 76.33% which falls short of WHO standard of minimum of 85%. Patients taking tuberculosis treatment in the centre are satisfied with the services rendered to them and the improvement in their health conditions. Unfriendly attitude of some health care providers in the facility is an area for intervention. Conclusion: Clinical and humanistic outcomes of tuberculosis treatment was found to be satisfactory in the facility owing to the level of treatment success and patient reported satisfaction with facility services and improvement in their health conditions.

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“…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.…”

Section: Data Collection Instrumentmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

2021

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Background Tuberculosis (TB) remains one of the most common infectious diseases worldwide. Although TB is curable provided the treatment commenced quickly, appropriately and uninterrupted throughout TB treatment duration. However, high default rate, treatment interruption and therapy non-adherence coupled with inadequate disease knowledge significantly contribute to poor TB treatment outcome, especially in developing countries. This study therefore assessed knowledge about TB and possible reasons for treatment non-adherence among drug-sensitive TB (DS-TB) patients, as well as evaluated treatment outcomes for the DS-TB managed within a 5-year period. Methods A mixed-method design comprising a cross-sectional questionnaire-guided survey among 140-ambulatory DS-TB patients from January–March 2019, and a retrospective review of medical-records of DS-TB managed from 2013 to 2017 in two WHO-certified TB directly-observed-treatment centres. Data were summarized using descriptive statistics, while categorical variables were evaluated with Chi-square at p < 0.05. Results Among the prospective DS-TB patients, males were 77(55.0%) and females were 63(45.0%). Most (63;45.0%) belonged to ages 18-34 years. A substantial proportion knew that TB is curable (137;97.9%) and transmittable (128;91.4%), while 107(46.1%) accurately cited coughing without covering the mouth as a principal mode of transmission. Only 10(4.0%) mentioned adherence to TB medications as a measure to prevent transmission. Inaccessibility to healthcare facility (33;55.0%) and pill-burden (10,16.7%) were topmost reasons for TB treatment non-adherence. Of the 2262-DS-TB patients whose treatment outcomes were evaluated, 1211(53.5%) were cured, 580(25.6%) had treatment completed, 240(10.6%) defaulted, 54(2.3%) failed treatment and 177(7.8%) died. Overall, the treatment success rate within the 5-year period ranged from 77.4 to 81.9%. Conclusions Knowledge about TB among the prospective DS-TB patients is relatively high, especially with respect to modes of TB transmission and preventive measures, but a sizeable number lacks the understanding of ensuring optimal TB medication-adherence to prevent TB transmission. Inaccessibility to healthcare facility largely accounts for treatment non-adherence. Outcomes of treatment within the 5-year period show that nearly half were cured, while almost one-tenth died. Overall treatment success rate is about 12% below the WHO-defined target. There is generally a need for concerned stakeholders to step-up efforts in ensuring consistent TB enlightenment, while improving access to TB care is essential for better treatment outcome.

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Trend and determinants of tuberculosis treatment outcome in a tertiary hospital in Southeast Nigeria

Cited by 13 publications

References 15 publications

Risk Factors of Tuberculosis Treatment Failure among Tuberculosis Patients in Khuzestan Province: A Retrospective Cohort Study

Risk Factors of Tuberculosis Treatment Failure among Tuberculosis Patients in Khuzestan Province: A Retrospective Cohort Study

Clinical and Humanistic Outcomes of Tuberculosis Treatment in a Nigerian Directly Observed Treatment Short Course Centre

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

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