Tuberculosis Treatment Outcome and Associated Factors Among Tuberculosis Patients Under Directly Observed Treatment Short-Course at Arba Minch General Hospital, Southern Ethiopia: A Five-Year Retrospective Study

Abstract

Background: Although directly observed treatment short course has been implemented among different countries, tuberculosis (TB) remains a major public health issue in the 21 st century and Ethiopia is the eighth highest-burden country in the world. Thus, assessment of TB treatment outcomes and its associated factors in DOTS are among the major indicators of the performance of a national TB control program. Objective: The aim of this study was to assess tuberculosis treatment outcome and associated factors among TB patients under directly observed treatment short-course at Arba Minch General Hospital TB clinic, Southern Ethiopia from September 2015 to August 2020.MethodsAn Institutional based retrospective study was conducted by reviewing the five years (1 st September 2015 to 30 th August 2020) TB treatment registries at the TB clinic of Arba Minch General Hospital. A total of 498 TB patients from the registration with complete information were enrolled. Patients’ data like age, sex, residence, type of TB, the status of TB case, smear result of PTB, HIV co-infection, year of TB diagnosis, and treatment outcomes were extracted from the TB treatment registration with a data collection checklist. SPSS version 25 statistical software was used for final data analysis. Results: From the overall enrolled TB patients, 312 (62.7%) were males and about 286 (57.4%) were from rural areas. In terms of TB type 94% were pulmonary TB, of which 66% were smear negative (PTB-) and 86.3% were new TB cases. The proportion of TB/HIV co-infection was 17.7%. Overall, 440 (88.4%) TB patients had successful treatment outcomes (28.5% cured and 59.9% completed treatment), while 11.6% patients had unsuccessful treatment outcomes (7.8% defaulted, 2.2 died, and 1.6% treatment failure). The unsuccessful TB treatment outcome was significantly associated with re-treatment TB cases [AOR=3.345, 95% CI: (1.739-6.436)], smear-negative PTB cases, [AOR = 2.558, 95% CI: (1.229-5.323)] and with EPTB [AOR = 4.817, 95% CI: (2.101-11.044)]. Conclusion: The high TB treatment success rate in our setting is in line the target set by the WHO. However, successful treatment outcome was very law in EPTB, re-treatment, and smear negative PTB cases. Therefore, targeted measures should be considered to decrease poor tuberculosis treatment outcomes among high-risk patients through; careful monitoring, making the DOTS program more accessible and counselling. Funding: This research was supported by Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Southern Ethiopia. Declaration of Interest: The authors declare that they have no conflicts of interest for this work. Ethical Approval: This study was approved by the Arba Minch University, College of Medicine and Health Sciences, Department of Medical Laboratory Sciences