Abstract
A retrospective study was conducted to assess TB treatment outcome and thus evaluate DOTS programme in Benishangul Gumuz Region, western Ethiopia. The records of 3658 TB patients registered in the two hospitals between November, 2003 and October, 2012 at DOTS Clinics were analyzed. From the total patients, 2,223 (60.77%) were successfully treated, 315 (8.61%) lost to follow up, 341 (9.32%) died, 4 (0.11%) failed treatment and 775 (21.19%) not evaluated. There is no association in treatment success rate between new and previously treated patients (60.55% vs. 58.33%, X2=0.14; P>0.704). When transferred out (not evaluated) is excluded, the success rate was increased approximately by a rate of 0.03 times while the time is increased by one year (β=0.03106; CI=0.0218-0.0403). Smear negative pulmonary TB patients had 1.24 times low treatment success rate (64.08% vs. 58.07%; CI=1.02-1.51; P<0.001) compared to smear positive. Patients from Pawe areas had 1.34 times lower treatment success rate compared to cases from Assosa (64.91% vs. 58.57%; CI=1.16-1.55). Not evaluated and lost to follow up rates were higher in Pawe (24.93% vs. 14.16%; X2=38.66; P<0.001 and 10.10% vs. 5.82%; X2=16.40; P<0.001 respectively) while death rate was higher in Assosa (14.95% vs. 6.33%; X2=59.05; P<0.001). Accordingly, males and elders had the trend to be more likely to experience death. In conclusion, the treatment success rate of TB patients was low which accounts for 60.77%. Low treatment success and high proportion of death (9.32%) and defaulted (8.61%) rates are serious public health concerns that point out low DOTs programme performance in the study areas.
Highlights
Despite the availability of an inexpensive, effective and reasonably well-tolerated therapy, TB is continuing as a major challenge to global public health in 21st century [1]
Though WHO recommends routine culture and drug susceptibility testing for M. tuberculosis to evaluate and follow up effectively the treatment outcomes, most developing countries including Ethiopia are not performing it; even for patients suspected of harboring drug-resistant strains
Demographic characteristics of patients A total of 3745 TB patients were registered in both hospitals between November, 2003 and October, 2012
Summary
Despite the availability of an inexpensive, effective and reasonably well-tolerated therapy, TB is continuing as a major challenge to global public health in 21st century [1]. One third of the world’s population, in developing countries is harboring bacilli in the form of latent or dormant infection. With latent TB, approximately 10% develop active TB during their life time. DOTs programme was started in 1992 as a standardized TB prevention and control strategy in Ethiopia. It was piloted in Arsi and Bale zone, Oromia Region. This strategy has been subsequently expanded in the country at national level. Though WHO recommends routine culture and drug susceptibility testing for M. tuberculosis to evaluate and follow up effectively the treatment outcomes, most developing countries including Ethiopia are not performing it; even for patients suspected of harboring drug-resistant strains
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