Tuberculosis treatment outcomes and associated factors in two states in Nigeria

Abstract

objective To determine the treatment success rate among TB patients and associated factors in Anambra and Oyo, the two states with the largest burden of tuberculosis in Nigeria. methods A health facility record review for 2016 was conducted in the two states (Anambra and Oyo). A checklist was used to extract relevant information from the records kept in each of the selected DOTS facilities to determine TB treatment success rates. Treatment success rate was defined as the proportion of new smear-positive TB cases registered under DOTS in a given year that successfully completed treatment, whether with bacteriologic evidence of success ('cured') or without ('treatment completed'). Treatment success rate was classified into good (≥85%) and poor (<85%) success rates using the 85% national target for TB treatment outcome. Data were analysed using descriptive statistics and chi-square at P < 0.05. results There were 1281 TB treatment enrollees in 2016 in Anambra and 3809 in Oyo (total = 4835). An overall treatment success rate of 75.8% was achieved (Anambra-57.5%; Oyo-82.0%). The percentage cure rates were 61.5% for Anambra and 85.2% for Oyo. Overall, only 28.6% of the facilities in both states (Anambra-0.0%; Oyo-60.0%) had a good treatment success rate. More facilities in Anambra (100.0%) than Oyo (40.0%) had a poor treatment success rate (p < 0.001), as did more private/FBO (100.0%) than public health facilities (60.0%) (p = 0.009). All tertiary facilities had a poor treatment success rate followed by 87.5% of secondary health facilities and 56.5% of primary healthcare facilities (P = 0.035). conclusion Treatment success and cure rates in Anambra state were below the 85.0% of the recommended target set by the WHO. Geographical location, and level/tier and type of facility were factors associated with this. Interventions are recommended to address these problems. keywords tuberculosis treatment enrollees, quality of training, supportive supervision, success rate, cure rate Sustainable Development Goals (SDGs): SDG 3 (good health and well-being), SDG 10 (reduced inequalities)

Tuberculosis and HIV/AIDS Co-infection in Patients Attending Directly Observed Treatment Short-Course (DOTS) Centers in Anambra State, Nigeria

“…Some of these centers are housed within secondary and tertiary health care facilities and are staffed by community health extension workers and/or nurses who are expected to diagnose, treat, and refer patients as needed. With the implementation of the DOTS strategy in the Nigeria, treatment success rates increased from 15% in 1995 to 86% in 2017, and case detection rates increased from 4.3% to 25.8% during the same period (Adebayo et al, 2020).…”

“…According to Adebayo et al (2020), the problems of limited access to healthcare services and poor quality of DOTS centers, as well as insufficient health service capacity to deliver effective TB services that will meet the needs of patients, pose a major challenge to achieving Nigeria’s TB control targets. The negative consequences of the high prevalence of TB and HIV/AIDS co-infection cases in Anambra State are obvious.…”

“…TB remains a serious public health challenge in Nigeria, and the country ranks among the nations with the highest disease burden. TB has a negative impact on the country’s growth and development because it causes both direct and indirect economic losses due to increased morbidity and mortality, and because a significant proportion of those affected are in productive age groups (Adebayo et al, 2020).…”

“…Several TB control programmes have been initiated in developing countries, most notably Nigeria, which has a high TB burden. They include the WHO-instituted direct observed treatment short course (DOTS) program, DOTSplus, and Stop TB, all with the mandate of executing strategies aimed at reducing the global TB burden (Ehondor et al, 2019; Adebayo et al, 2020; WHO, 2012).…”

“…TB has a negative impact on the country’s growth and development because it causes both direct and indirect economic losses due to increased morbidity and mortality, and because a significant proportion of those affected are in productive age groups. 5…”