Predictors of unsuccessful treatment of tuberculosis in Arsi-Robe Hospital, Arsi Zone, Oromia Regional State, Central Ethiopia: a retrospective study

Abstract

ABSTRACT Introduction Tuberculosis remains a major global health problem and ranks alongside the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. This study investigated the treatment outcome of tuberculosis and predictors of unsuccessful treatment outcome of tuberculosis (TB) patients enrolled in Arsi-Robe Hospital, central Ethiopia between January 2013 and December 2017. Methods An institution-based retrospective study was conducted on patients who had all forms of TB such as smear positive tuberculosis (PTB+), smear negative tuberculosis (PTB-), and extrapulmonary tuberculosis (EPTB) in the DOTS clinic. A multivariable logistic regression model was employed to identify predictors of unsuccessful treatment outcome and a P < 0.05 was considered statistically significant. Results Out of 257 registered TB patients, most were males (60%), rural residents (62.6%), new cases (69.6%), and HIV-negative (91.4%) and had pulmonary TB (80.2%). Regarding treatment outcome, 31.5% were cured, 52.5% completed their treatment, 5.1% defaulted, 5.8% died, and 5.1% had failed treatment. The overall successful treatment outcome and unsuccessful treatment outcome were 84% (87.9% males and 78.7% females) and 16% (21.1% males and 21.3% females), respectively. TB patients’ residence, age, treatment category, HIV-status and TB types were significantly associated with unsuccessful treatment outcome. TB patients from urban areas [AOR, adjusted odds ratio: 3.34, 95% CI (1.33–8.38)], within age of 45–54 years [AOR: 2.35, 95% CI (1.03–6.98)], those with failure treatment [AOR: 6.64, 95% CI (1.12–37.08)], and HIV-positive [AOR: 5.02, 95% CI (1.50–16.82)] patients had higher odds of unsuccessful TB treatment outcome. However, patients with PTB+ and EPTB had significantly lower odds of unsuccessful treatment outcome compared to patients with PTB-. Conclusion and Recommendations The treatment success rate is low as compared to the national treatment success rate. Public health facilities are advised to work on identifying factors of unsuccessful treatment outcomes through strengthened implementation of the DOTS strategy.