Abstract
BackgroundGlobally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos-North and Mangu Local Government Areas of Plateau State, North-Central Nigeria.MethodsThe retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10,156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariate and multivariate logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.ResultsDuring the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The 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. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. The factors associated with treatment success were gender, age, year of enrollment, and HIV status. Extrapulmonary TB was less likely associated with treatment success (AOR:95% CI- 0.72:0.61–0.84, p < 0.001).ConclusionWith the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.
Highlights
Tuberculosis (TB) is the leading cause of death from a single infectious agent
Majority of the TB patients were in the productive age of 24–35 years of age (33.4%) and were Human Immunodeficiency Virus (HIV) positive (38.4%)
This study was conceptualized to assess and understand the factors associated with treatment outcomes in TB patients who received treatment at selected treatment facilities in Plateau State, North-central Nigeria, with more focus on the effect HIV has on the TB treatment outcomes
Summary
Tuberculosis (TB) is the leading cause of death from a single infectious agent. Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis It is a major global public health concern being the tenth leading cause of death worldwide, and the leading cause of death from a single infectious agent since 2011, ahead of the Human Immunodeficiency Virus (HIV) disease [1]. The global treatment success rate was 82% among all new TB cases [1]. TB treatment saved 53 million lives globally (including HIV positive TB patients) and 11 million lives were saved in Africa. There are 30 high TB burden countries (HBCs) which collectively have about 87% of the world’s TB cases. Nigeria is among the 14 countries with overlap of high burden of TB, TB/HIV and multidrug resistantTB (MDR-TB). The total TB incidence rate in Nigeria was 219/100,000 population (population of 191 million people), out of which of 14% were HIV positive [1]
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