Treatment outcome of smear-positive pulmonary tuberculosis patients in Tigray Region, Northern Ethiopia

Gebretsadik Berhe,Abraham Aseffa,Fikre Enquselassie

doi:10.1186/1471-2458-12-537

Abstract

BackgroundMonitoring the outcome of tuberculosis treatment and understanding the specific reasons for unsuccessful treatment outcome are important in evaluating the effectiveness of tuberculosis control program. This study investigated tuberculosis treatment outcomes and predictors for unsuccessful treatment outcome in the Tigray region of Ethiopia.MethodsMedical records of smear-positive pulmonary tuberculosis (PTB) patients registered from September 2009 to June 2011 in 15 districts of Tigray region, Northern Ethiopia, were reviewed. Additional data were collected using a structured questionnaire administered through house-to-house visits by trained nurses. Tuberculosis treatment outcomes were assessed according to WHO guidelines. The association of unsuccessful treatment outcome with socio-demographic and clinical factors was analyzed using logistic regression model.ResultsOut of the 407 PTB patients (221 males and 186 females) aged 15 years and above, 89.2% had successful and 10.8% had unsuccessful treatment outcome. In the final multivariate logistic model, the odds of unsuccessful treatment outcome was higher among patients older than 40 years of age (adj. OR = 2.50, 95% CI: 1.12-5.59), family size greater than 5 persons (adj. OR = 3.26, 95% CI: 1.43-7.44), unemployed (adj. OR = 3.10, 95% CI: 1.33-7.24) and among retreatment cases (adj. OR = 2.00, 95% CI: 1.37-2.92) as compared to their respective comparison groups.ConclusionsTreatment outcome among smear-positive PTB patients was satisfactory in the Tigray region of Ethiopia. Nonetheless, those patients at high risk of an unfavorable treatment outcome should be identified early and given additional follow-up and social support.

Highlights

Monitoring the outcome of tuberculosis treatment and understanding the specific reasons for unsuccessful treatment outcome are important in evaluating the effectiveness of tuberculosis control program
Socio-demographic and clinical factors A review of the treatment records of 407 smear-positive pulmonary tuberculosis (PTB) patients was retrieved from all health centers found in the study districts
Assessment of treatment outcome and analysis of factors responsible for unsuccessful treatment outcome in directly observed treatment- short course (DOTS) programs is of paramount importance in smear-positive PTB patients as they harbor a highly contagious form of M. tuberculosis that can be

Summary

Introduction

Monitoring the outcome of tuberculosis treatment and understanding the specific reasons for unsuccessful treatment outcome are important in evaluating the effectiveness of tuberculosis control program. Despite the availability of highly effective treatment for decades, tuberculosis (TB) remains a major global health problem. In 2010, there were an estimated 8.5–9.2 million new cases and 1.2–1.5 million deaths worldwide [1]. According to the WHO Global TB report 2011, Ethiopia ranks 8th in the list of 22 high burden countries (HBCs), and 3rd in Africa, with an estimated prevalence of all forms of TB in 394 per 100,000 population [1]. Ethiopia started implementing DOTS within a standardized TB prevention and control program in 1992 [7]. Ethiopia reports treatment success and case detection rates of 83% and 72% of all forms of TB, respectively. DOTS coverage is estimated at 100% geographical and 95% health facility level [8]

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