Tuberculosis treatment success rate, associated factors and outcomes in St.Kizito Hospital, Matany, Napak district, Karamoja region. A retrospective study.

Abstract

Background Tuberculosis (TB) is the leading cause of death from a single infectious agent globally. An estimated 10 million people are newly diagnosed and 1.5 million die of the disease annually. Uganda is among the 30 high TB burdened countries, with Karamoja having a significant contribution of the disease incidence in the country. Control of the disease in Karamoja is complex because a majority of the at risk population remain mobile; partly because of the normadic lifestyle. This study, therefore, aimed at describing the factors associated with TB treatment success rate (TSR) in the Karamoja region. Methods This was a retrospective study on case notes of all individuals diagnosed with and treated for drug-susceptible TB at St. Kizito Hospital Matany, Napak district, Karamoja from 1st Jan 2020 to 31st December 2021. Data were abstracted using a customised proforma. Data analyses were done using Stata statistical software, version 15.0. Chi square test was used to compare treatment success rate between year 2020 and 2021, while Modified Poisson regression analysis was performed at multivariable level to determine the factors associated with treatment success. Results We studied records of 1234 participants whose median age was 31 (IQR: 13–49) years. Children below 15 years of age accounted for 26.2% (n = 323). The overall treatment success rate for the study period was 79.3%(95%CI; 77.0%-81.5%), with a statistically significant variation in 2020 and 2021, 75.4% (422/560) vs 82.4% (557/674) respectively, (P = 0.002). The commonest repported treatment outcome was treatment completion at 52%(n = 647) and death was at 10.4% (n = 129). Older age, undernutrition (Red MUAC) and HIV positive status were significantly associated with lower treatment success: aPR = 0.87(95%CI; 0.80–0.94), aPR = 0.91 (95%CI; 0.85–0.98) and aPR = 0.88 (95%CI; 0.78–0.98); respectively. Patients who were enrolled in 2021 had high prevalence of treatment success compared to those enrolled in 2020, aPR = 1.09 (95%CI; 1.03–1.16). Conclusion TB TSR in Matany hospital was suboptimal. Older age, poor nutrition and being HIV positive were negative predictors of treatment success. We propose integrating nutrition and HIV care into TB programming to improve treatment success.