Analysis of Tuberculosis Cases Notification and Treatment Outcomes Among Refugee Camps In Kenya: Four Year Retrospective Study, 2014-2017

Abstract Background: Tuberculosis (TB) is more severe in refugee populations. Analyzing the key indicators of TB program performance is important to improve the effectiveness of TB control in the refugee camps. This study aimed to analyze trends in TB case notification, treatment outcomes and factors associated with unsuccessful TB treatment in Dadaab and Kakuma refugee camps in Kenya. Methods: In this descriptive retrospective study, demographic and clinical data all TB cases registered in the refugee camps from January 2014 to December 2017 were extracted. Multiple logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for variables associated with unsuccessful TB treatment.Results. A total of 2055 TB cases of whom 56.8% men and 57.7% age 15-44 years were registered. Number of notified cases decreased from 532 in 2014 to 473 in 2016 (11.1% decrease) then increased to 554 in 2017(16.9% increase in one year). From 2014 to 2017 there was consistent increase in percentage of EPTB (16.2% to 21.1%), and in contribution of children (<15 years) to total TB cases (20.3% to 25.8%) and to EPTB (36.1% to 44.4%). Proportion of bacteriologically confirmed new and relapse pulmonary cases increased from 49.5% to 60.9%. Treatment success rate remained higher at 92.6% to 94.4%. On average 41.7% were cured, 2.3% lost to follow-up (LTFU) (increasing from 1.3% to 3.2%), 2.2% died (decreasing from 2.4% to 1.6%), 1.6% not evaluated (decreasing from 3.2% to 1.3%), and 0.5% treatment failed. Unsuccessful treatment outcome was significantly associated with pretreatment weight < 40 Kg, being male, smear positive PTB, HIV infection, and age >15 years (increased with age).Conclusions: Number of notified TB cases has decreased from 2014 to 2016, but increased in 2017. There was continuous increase in percentage of EPTB and childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases has increased overtime. Treatment success remained higher above global target (90%) which should be maintained. Special socioeconomic support and follow-up is required for TB patients who are at higher risk of unsuccessful treatment.

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Tuberculosis (TB) in the refugee camps in Ethiopia: trends of case notification, profile, and treatment outcomes, 2014 to 2017

BMC Infectious Diseases ◽

10.1186/s12879-021-05828-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Continuous Increase ◽

Unsuccessful Treatment ◽

Childhood Tb ◽

Measure Of Association ◽

Case Notification

Abstract Background Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. Results A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2 to 32.7%), in contribution of children to total TB cases (18.8 to 30.1%) and to EPTB (40.6 to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8 to 64.8%). Treatment success rates for all TB cases remained lower at 72.7–79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. Conclusions There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (> = 90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Tuberculosis (TB) in the refugee camps in Ethiopia: Trends of case notification, profile, and treatment outcomes, 2014 to 2017

10.21203/rs.3.rs-52830/v3 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Continuous Increase ◽

Unsuccessful Treatment ◽

Childhood Tb ◽

Measure Of Association ◽

Case Notification

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods: In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes. Results: A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2% to 32.7%), in contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8% to 64.8%). Treatment success rates for all TB cases remained lower at 72.7%-79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive. Conclusions: There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (>=90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Tuberculosis (TB) in the refugee camps in Ethiopia: Trends of case notification, profile, and treatment outcomes, 2014 to 2017

10.21203/rs.3.rs-52830/v2 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Continuous Increase ◽

Unsuccessful Treatment ◽

Childhood Tb ◽

Measure Of Association ◽

Case Notification

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to improve the effectiveness of TB programs. This study aimed to investigate trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia.Methods: In this retrospective cohort study, demographic and clinical data of all TB cases registered in 25 refugee camps in Ethiopia from January 2014 to December 2017 were extracted. Multivariate logistic regression was fitted to estimate odds ratios and corresponding 95% confidence intervals for the measure of association linked with factors significantly associated with unsuccessful treatment outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered from 2014 to 2017. Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in number of notified TB cases (138 to 588 cases), in percentage of EPTB (23.2% to 32.7%), in contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%), and in proportion of bacteriologically confirmed new and relapse pulmonary cases (43.8% to 64.8%). Treatment success rates for all TB cases remained lower at 72.7%-79.4%. On average 24.8% had unfavorable treatment outcome, including 11.5% not evaluated, 8.0% LTFU, 4.8% died and 0.5% treatment failed. Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: There was continuous increase in notified TB cases and in percentage of childhood TB. Proportion of bacteriologically confirmed new and relapse pulmonary cases increased overtime. TB treatment success remained lower than the national achievement in 2017 (96%) and global target (>=90%), which needs improvement. The higher LTFU, not evaluated, and death suggests the need to strengthen adherence education and supervision. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives.

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Tuberculosis (TB) in the Refugee Camps in Ethiopia: Trends of Case Notification, Profile, and Treatment Outcomes, 2014 to 2017

10.21203/rs.3.rs-52830/v1 ◽

2020 ◽

Author(s):

Tsegay Legesse ◽

Goitom Admenur ◽

Selemawit Gebregzabher ◽

Eyob Woldegebriel ◽

Bexabeh Fantahun ◽

...

Keyword(s):

Treatment Outcomes ◽

Data Extraction ◽

Treatment Success ◽

Refugee Camps ◽

Success Rates ◽

Factors Associated ◽

Unsuccessful Treatment ◽

Economic Support ◽

Childhood Tb ◽

Case Notification

Abstract Background: Severity of TB increases in refugee populations. Monitoring TB case notification and treatment outcomes are essential to evaluate the effectiveness of TB programs. This study aimed to determine trends in TB case notification and treatment outcomes and explore factors associated with unsuccessful treatment outcome in refugee camps in Ethiopia. Methods: This retrospective cohort study was conducted from October 2018-June 2019. Demographic and clinical data of all TB cases registered from 2014 to 2017 in 25 refugee camps located in seven refugee areas (Shire, Afar, Gambella, Asossa, Mizam, Jijiga, and Dollo Ado) were extracted using pre-tested data extraction format. Multivariate logistic regression was performed to calculate odds ratios and 95% confidence intervals for factors associated with unsuccessful outcomes.Results. A total of 1553 TB cases, mean age 27.7 years, were registered (2014-2017). Of these notified cases 54.7% were men, 27.7% children (< 15 years), 71.2% pulmonary TB (PTB), 27.8% Extra-PTB (EPTB) and 98.3% new and relapse. From 2014 to 2017: there was consistent increase in the number of notified TB cases (138 to 588 cases), in the percentage of EPTB (23.2% to 32.7%), bacteriologically confirmed pulmonary new and relapse (43.8% to 64.8%), and contribution of children to total TB cases (18.8% to 30.1%) and to EPTB (40.6% to 65.1%). Treatment success rates for all TB cases remained lower at 72.7%-79.4% (on average 11.7% were not evaluated, 8.0% lost to follow-up (LTFU), 4.8% died, and 0.5% failed). Unsuccessful treatment was significantly associated with pretreatment weight below 40 Kg, age over 45 years, and being HIV positive.Conclusions: This study has provided valuable evidences that can help to improve the TB programs. There was increased trend in number of notified TB cases, and in proportion of EPTB, childhood TB, and bacteriologically confirmed pulmonary new and relapse cases. Treatment success rate (2014-2017) was far below global target (90%), and “not evaluated” and LTFU treatment outcomes were higher, which need to be improved. Special socio-economic support and monitoring is required for patients with pretreatment weight below 40 Kg, age over 45 years and HIV positives who at risk for unsuccessful treatment.

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Trends of Tuberculosis Treatment Outcomes of Notified Cases in Three Refugee Camps in Sudan: A Four-year Retrospective Analysis, 2014–2017

Sudan Journal of Medical Sciences ◽

10.18502/sjms.v16i2.9293 ◽

2021 ◽

Author(s):

Tsegay Legesse ◽

Mohammed Hussein Elduma ◽

Nagi Masoud Awad ◽

Mousab Siddig Elhag ◽

Israa Abushama ◽

...

Keyword(s):

Treatment Outcome ◽

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

Treatment Success Rate ◽

Refugee Camps ◽

Historical Cohort ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

Lost To Follow Up

Background: Refugees are vulnerable to tuberculosis (TB) infection. Tracking of program performance is needed to improve TB care and prevention. The objective of this study was to assess the trends of TB treatment outcomes of notified cases in three refugee camps in Sudan from 2014 to 2017. Methods: This study was a historical cohort study. Sex, age, type of TB, TB patient category, and treatment outcome of all TB cases registered in three refugee camps (Al Kashafa, Shagarab, Wadsherify) from January 1, 2014 to December 31, 2017 were collected from the TB register. Multivariable logistic regression was performed to explore factors for unsuccessful TB treatment. Results: A total of 710 TB cases of which 53.4% were men, 22.1% children (<15 years), and 36.2% extrapulmonary TB (EPTB) were registered. Overall, the TB treatment success rate was 75.7% with a declining trend from 86.2% in 2015 to 63.5% in 2017. On average, 11.4% were lost to follow-up (LTFU), 6.6% died, 5.9% were not evaluated, and in 0.3% the treatment failed. Being 15–24 years old and having EPTB were significantly associated with unsuccessful treatment outcome. Conclusion: The treatment success rate in the refugee camp in 2017 (63.5%) was far lower than the national treatment success rate (78%) and the End TB global target (≥90%) that needs to be improved. LTFU, died, and not evaluated outcomes were high which indicated the necessity to improve the TB treatment program.

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Tuberculosis Treatment Outcome and Predictors in Africa: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010678 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10678

Author(s):

Melese Yeshambaw Teferi ◽

Ziad El-Khatib ◽

Minyahil Tadesse Boltena ◽

Azeb Tarekegn Andualem ◽

Benedict Oppong Asamoah ◽

...

Keyword(s):

High Risk ◽

Success Rate ◽

Treatment Outcomes ◽

Treatment Success ◽

Treatment Success Rate ◽

Diagnostic Modality ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

Increased Risk

This review aimed to summarize and estimate the TB treatment success rate and factors associated with unsuccessful TB treatment outcomes in Africa. Potentially eligible primary studies were retrieved from PubMed and Google Scholar. The risk of bias and quality of studies was assessed using The Joanna Briggs Institute’s (JBI) appraisal criteria, while heterogeneity across studies was assessed using Cochran’s Q test and I2 statistic. Publication bias was checked using the funnel plot and egger’s test. The protocol was registered in PROSPERO, numbered CRD42019136986. A total of 26 eligible studies were considered. The overall pooled estimate of TB treatment success rate was found to be 79.0% (95% CI: 76–82%), ranging from 53% (95% CI: 47–58%) in Nigeria to 92% (95% CI: 90–93%) in Ethiopia. The majority of unsuccessful outcomes were attributed to 48% (95% CI: 40–57%) death and 47% (95% CI: 39–55%) of defaulter rate. HIV co-infection and retreatment were significantly associated with an increased risk of unsuccessful treatment outcomes compared to HIV negative and newly diagnosed TB patients with RR of 1.53 (95% CI: 1.36–1.71) and 1.48 (95% CI: 1.14–1.94) respectively. TB treatment success rate was 79% below the WHO defined threshold of 85% with significant variation across countries. Countries need to explore contextual underlining factors and more effort is required in providing TB preventive treatment, improve case screening and linkage for TB treatment among HIV high-risk groups and use confirmatory TB diagnostic modality. Countries in Africa need to strengthen counseling and follow-up, socio-economic support for patients at high risk of loss to follow-up and poor treatment success is also crucial for successful TB control programs.

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Epidemiology of tuberculosis and treatment outcomes among children in Pakistan: a 5 year retrospective study

PeerJ ◽

10.7717/peerj.5253 ◽

2018 ◽

Vol 6 ◽

pp. e5253 ◽

Cited By ~ 4

Author(s):

Madeeha Laghari ◽

Syed Azhar Syed Sulaiman ◽

Amer Hayat Khan ◽

Naheed Memon

Keyword(s):

Retrospective Study ◽

Treatment Outcomes ◽

Urban Areas ◽

Demographic Data ◽

Treatment Success ◽

Clinical Manifestations ◽

Sputum Smear ◽

Unsuccessful Treatment ◽

Patients At Risk ◽

Group 2

Background Regardless of the advancement in medical technologies, the diagnosis of tuberculosis (TB) in children has remained a challenge. Childhood TB is rampant and an important cause of morbidity and mortality. The objective of this study was to determine the trend of TB and treatment outcomes in children aged ≤14 years registered for TB treatment under DOTS course in three districts of Sindh, Pakistan. Methods For this retrospective study, records of TB children (≤14 years) registered for the treatment of TB from January 2011 to December 2015 in three districts of Pakistan, were collected. Demographic data, baseline weight, clinical manifestations, radiography, histopathology results and treatment outcomes were collected from TB unit registers. Results A total of 2,167 children were treated for TB during the study period. Of these, 1,199 (55.3%) were females and 1,242 (57.3%) were from urban areas. Over three-quarter of patients (76.9%) had pulmonary TB with 13.3% of sputum smear positive cases. The overall treatment success rate was 92.4%. In multivariate analysis, rural residents (OR: 2.146, p < 0.001), sputum smear positive cases (OR: 3.409, p < 0.001) and re-treated patients (OR: 5.919, p < 0.001), were significantly associated with unsuccessful treatment outcomes. However, age group ≤2 years, male and those who were underweight were found to have the highest risk of pulmonary tuberculosis (OR: 1.953, p < 0.001; OR: 1.262, p = 0.028; OR: 1.342, p = 0.008), respectively. Conclusion Patients at risk of treatment failure must be given particular attention. Moreover, strategies are needed to further improve the diagnosis and treatment of TB among children and improve the recording system.

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Catastrophic costs due to tuberculosis worsen treatment outcomes: a prospective cohort study in Indonesia

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa038 ◽

2020 ◽

Vol 114 (9) ◽

pp. 666-673

Author(s):

Ahmad Fuady ◽

Tanja A J Houweling ◽

Muchtaruddin Mansyur ◽

Erlina Burhan ◽

Jan Hendrik Richardus

Keyword(s):

Treatment Outcomes ◽

Treatment Adherence ◽

Mixed Models ◽

Multivariable Analysis ◽

Annual Household Income ◽

Rural Districts ◽

Tb Treatment ◽

Unsuccessful Treatment ◽

One Year

Abstract Background While the incidence of catastrophic costs due to tuberculosis (TB) remains high, there is little evidence about their impact on TB treatment outcomes and adherence. We assessed their effect on treatment outcomes and adherence in Indonesia. Methods We interviewed 282 adult TB patients who underwent TB treatment in urban, suburban and rural districts of Indonesia. One year after the interview, we followed up treatment adherence and outcomes. We applied multivariable analysis using generalized linear mixed models. Results Follow-up was complete for 252/282 patients. Eighteen (7%) patients had unsuccessful treatment and 40 (16%) had poor adherence. At a threshold of 30% of annual household income, catastrophic costs negatively impacted treatment outcomes (adjusted odds ratio [aOR] 4.15 [95% confidence interval {CI} 1.15 to 15.01]). At other thresholds, the associations showed a similar pattern but were not statistically significant. The association between catastrophic costs and treatment adherence is complex because of reverse causation. After adjustment, catastrophic costs negatively affected treatment adherence at the 10% and 15% thresholds (aOR 2.11 [95% CI 0.97 to 4.59], p = 0.059 and aOR 2.06 [95% CI 0.95 to 4.46], p = 0.07). There was no evidence of such an effect at other thresholds. Conclusions Catastrophic costs negatively affect TB treatment outcomes and treatment adherence. To eliminate TB, it is essential to mitigate catastrophic costs.

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Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018

10.21203/rs.2.17443/v1 ◽

2019 ◽

Author(s):

Peter Okpeh Amede ◽

Elizabeth Adedire ◽

Aishat Usman ◽

Celestine A. Ameh ◽

Faruk S. Umar ◽

...

Keyword(s):

Treatment Outcome ◽

Treatment Outcomes ◽

Tracking System ◽

Treatment Success ◽

Incidence Rates ◽

Prison Inmates ◽

Successful Treatment Outcome ◽

Tb Treatment ◽

Hiv Negative

Abstract Background: Tuberculosis (TB) is a contagious disease and its transmissibility potential is increased in congregate settings like the prisons. TB incidence rates are five to fifty times higher among prison inmates than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its predictors in Nigerian prisons. We therefore assessed TB treatment outcomes among prison inmates in Bauchi State, Nigeria. Method: We conducted a retrospective data analysis of inmates with TB in the five main prisons in Bauchi State. We extracted sociodemographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a standardized checklist. We estimated the TB treatment success rate (TSR) and explored the relationship between the TSR and sociodemographic and clinical characteristics. Related variables were modelled in multivariate logistic regression to identify predictors of TSR at 5% level of significance. Results: All 216 inmates were male with mean age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 48 (22.2%) were lost to follow-up, 17 (7.9%) were transferred out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Odds of successful treatment outcome were age; 20-29 years (AOR=10.5; 95% CI: 3.2-35.1), 30-39 years (AOR=4.2; 95% CI: 1.3-13.1), pretreatment weight; 50-59 kg (AOR= 9.6; 95% CI: 1.4-65.6), ≥60 kg (AOR= 18.6; 95% CI: 2.5-140.1) and being HIV negative (AOR=3.3; 95% CI:1.4-7.8). Conclusion: The predictors of successful TB treatment outcome were being less than 40 years of age, having a pretreatment body weight of or greater than 50 kg, imprisonment for less than 2 years, and being HIV negative. We recommended that to improve TB TSR among prison inmates; age, duration of imprisonment, weight and TB/HIV coinfection should be the major consideration during drugs adherence, psychological and nutritional counselling and a tracking system be developed by the prisons authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated. Key words: Tuberculosis, Treatment outcomes, Prison inmates, Predictors, Bauchi State, Nigeria

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Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study In Jos North And Mangu, Plateau State, North - Central Nigeria

10.21203/rs.2.11227/v2 ◽

2019 ◽

Author(s):

Comfort Nanbam Sariem ◽

Patricia Odumosu ◽

Maxwell Patrick Dapar ◽

Jonah Musa ◽

Luka Ibrahim ◽

...

Keyword(s):

Retrospective Study ◽

Treatment Failure ◽

Treatment Outcomes ◽

Treatment Success ◽

Infectious Agent ◽

Tuberculosis Treatment ◽

Patient Treatment ◽

North Central ◽

Unsuccessful Treatment ◽

Plateau State

Abstract Background Tuberculosis (TB) disease is the leading cause of death from a single infectious agent globally. Medication adherence will be more valuable if it improves clinical/treatment outcomes of the patient because treatment outcomes are major indicators for evaluating TB therapy. Objective To examine a fifteen-year record of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State. Methods The retrospective registry based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. Data were collected from 10,156 TB patient’s health records from 2001 to 2015. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). Analysis was done descriptively and factors associated with treatment outcomes were determined using multiple logistic regression with the aid of Stata version 11. Results Males were 58.1% of the population (10,156). Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment; sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes from 83.8% to 64.4%, with a corresponding increase in unsuccessful treatment outcomes was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p =0.028) more likely to be associated with treatment success than having an unknown status. TALF/RAD, relapse and MDR-TB were less likely associated with treatment success than newly diagnosed TB patients Conclusion Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health system through adherence counseling, increased education on voluntary counseling and testing of HIV among TB patients. Keywords: Tuberculosis, Treatment Outcomes, Retrospective Study, Nigeria

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