Abstract:

Background: Tuberculosis (TB) is one of the top 10 causes of death worldwide, and the leading cause from a single infectious agent (above HIV/AIDS). Globally, 10.0 million people developed TB disease in 2017 with an estimated 1.6 million deaths. We conducted this study to determine predictors of treatment outcomes among tuberculosis patients treated at specialist hospital, Sokoto State, Nigeria.

Methods: A retrospective cohort study was conducted using medical record of 1501 patients treated of tuberculosis between January, 2014 and January, 2017. Treatment outcomes and TB cases were classified according to National TB control program guidelines. Bivariate and multivariate analysis was conducted to identify predictors of unsuccessful treatment outcomes. Odds ratio (OR) and 95% confidence interval (CI) was calculated. P- value of 0.05 was considered as statistically significant.

Result: Of the 1,501 patients treated; 72.2% were males with mean age of 36.5 ±14.9 years. Pulmonary TB accounts for 1,143 (76.2%) cases. A total of 174 (11.6%) were co-infected with HIV. successful outcomes accounts for 1,229 (81.9%) cases. Previously treated cases 89 (5.9%). Of the cases, 44 (2.9%) died. Being previously treated (P < 0.001) and co-infection with HIV(p<0.001) are independent predictors of poor treatment outcomes.

Conclusion: The treatment success rate was low as compared to the national target. Therefore, targeted interventions of high-risk patients are recommended.

Keywords: Tuberculosis, Treatment outcomes, DOT, Sokoto.

References:

[1].   Agbaji, C., Ebonyi, O., Meloni, A. O., Anejo-Okopi, S. T., & Akanbi, J. A. (2013). Factors Associated with Pulmonary Tuberculosis-HIV Co-Infection in Treatment-Naive Adults in Jos. North Central Nigeria. J AIDS Clin Res, 4, 222. https://doi.org/10.4172/2155-6113.1000222.

[2].   Aniwada, E., Onodugo, O., Onwasigwe, C., & Ajayi, O. (2018). Appraising Treatment Outcomes of Cohort of Smear-positive Patients with Tuberculosis (TB) alone and TB-HIV Co-infected on Directly Observed Treatment Short Course (DOTS) at a Teaching Hospital in Enugu State, Nigeria. Journal of Advances in Medicine and Medical Research, 27(3), 1–8. https://doi.org/10.9734/jammr/2018/42909.

[3].   Atif, M., Anwar, Z., Fatima, R. K., Malik, I., Asghar, S., & Scahill, S. (2018). Analysis of tuberculosis treatment outcomes among pulmonary tuberculosis patients in Bahawalpur, Pakistan. BMC Research Notes, 11(1), 370. https://doi.org/10.1186/s13104-018-3473-8.

[4].   Babatunde, O. A., Elegbede, O. E., Ayodele, M., Fadare, J.., Isinjaye, A. O., Ibirongbe, D.., & Akinyandenu, J. (2013). Factors Affecting Treatment Outcomes of Tuberculosis in a Tertiary Health Center in Southwestern Nigeria. International Review of Social Sciences and Humanities, 4(2), 209–218.

[5].   Belay, M., Bjune, G., & Abebe, F. (2015). Prevalence of tuberculosis, HIV, and TB-HIV co-infection among pulmonary tuberculosis suspects in a predominantly pastoralist area, northeast Ethiopia. Global Health Action, 8(5), 1–7. https://doi.org/10.3402/gha.v8.27949.

[6].   Biadglegne, F., Anagaw, B., Debebe, T., Anagaw, B., Tesfaye, W., Tessema, B., … Sack, U. (2013). A retrospective study on the outcomes of tuberculosis treatment in Felege Hiwot Referral Hospital, Northwest Ethiopia. International Journal of Medicine and Medical Sciences, 5(2), 85–91. https://doi.org/10.5897/IJMMS12.142.

[7].   Choi, H., Lee, M., Chen, R. Y., Kim, Y., Yoon, S., Joh, J. S., … Cho, S.-N. (2014). Predictors of pulmonary tuberculosis treatment outcomes in South Korea: a prospective cohort study, 2005-2012. BMC Infectious Diseases, 14(1), 360. https://doi.org/10.1186/1471-2334-14-360.

[8].   Daniel Tarekegne, M. J., Tarekegne, D., Atanaw, T., Ebabu, A., Endris, M., Tessema, B., … Deressa, T. (2014). Treatment Outcomes of Tuberculosis Patients in Metema Hospital, Northwest Ethiopia: A Four Years Retrospective Study. Mycobacterial Diseases, 05(04). https://doi.org/10.4172/2161-1068.1000190.

[9].   Denegetu, A. W., & Dolamo, B. L. (2014). HIV screening among TB patients and co-trimoxazole preventive therapy for TB/HIV patients in Addis Ababa: Facility based descriptive study. PLoS ONE, 9(2), 1–7. https://doi.org/10.1371/journal.pone.0086614.

[10].  Deribew, A., HaileMichael, Y., Tesfaye, M., Desalegn, D., Wogi, A., & Daba, S. (2010). The synergy between TB and HIV co-infection on perceived stigma in Ethiopia. BMC Research Notes, 3(1), 249. https://doi.org/10.1186/1756-0500-3-249.

[11].  El-Shabrawy, M., & El-Shafei, D. A. (2017). Evaluation of treatment failure outcome and its predictors among pulmonary tuberculosis patients in Sharkia Governorate, 2013-2014 The Egyptian Society of Chest Diseases and Tuberculosis. Egyptian Journal of Chest Diseases and Tuberculosis, 66, 145–152. https://doi.org/10.1016/j.ejcdt.2015.11.002.

[12].  Fatiregun, A. A., Ojo, A. S., & Bamgboye, A. E. (2009). Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria. Annals of African Medicine, 8(2), 100–104. https://doi.org/10.4103/1596-3519.56237.

[13].  Fatiregun, A., Ojo, A., & Bamgboye, A. (2009). Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria. Annals of African Medicine, 8(2), 100. https://doi.org/10.4103/1596-3519.56237.

[14].  FEDERAL MINISTRY OF HEALTH DEPARTMENT OF PUBLIC HEALTH. (n.d.).

[15].  Gabida, M., Tshimanga, M., Chemhuru, M., Gombe, N., Bangure, D., Belay, T., … Duru, C. (2015). Trends for Tuberculosis Treatment Outcomes, New Sputum Smear Positive Patients in Kwekwe District, Zimbabwe, 2007-2011: A Cohort Analysis. Journal of Tuberculosis Research, 03(04), 126–135. https://doi.org/10.4236/jtr.2015.34019.

[16].  Gadoev, J., Asadov, D., Tillashaykhov, M., Tayler-Smith, K., Isaakidis, P., Dadu, A., … Dara, M. (2015). Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study. https://doi.org/10.1371/journal.pone.0128907.

[17].  Gebrezgabiher, G., Romha, G., Ejeta, E., Asebe, G., Zemene, E., & Ameni, G. (2016). Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study. PloS One, 11(2), e0150560. https://doi.org/10.1371/journal.pone.0150560.

[18].  global. (2018).

[19].  Ifebunandu, N. A., & Ukwaja, K. N. (2012). Tuberculosis treatment default in a large tertiary care hospital in urban Nigeria: Prevalence, trend, timing and predictors. Journal of Infection and Public Health, 5, 340–345. https://doi.org/10.1016/j.jiph.2012.06.002.

[20].  Johnson, H. D., Dayalan, M. R., Wei, C. C., Kasinathan, G., Navarathnam, P., & Pillai, N. (2016). Predictors of Tuberculosis Treatment Outcome in an Urban Setting: A Retrospective Cohort Study. American Journal of Infectious Diseases and Microbiology, Vol. 4, 2016, Pages 14-21, 4(1), 14–21. https://doi.org/10.12691/AJIDM-4-1-3.

[21].  Lawn, S. D. (2009). Tuberculosis and HIV co-infection. Medicine, 37(12), 654–656. https://doi.org/10.1016/j.mpmed.2009.09.005.

[22].  Liew, S. M., Khoo, E. M., Ho, B. K., Lee, Y. K., Mimi, O., Fazlina, M. Y., … Jiloris, F. D. (2015). Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry. The International Journal of Tuberculosis and Lung Disease: The Official Journal of the International Union against Tuberculosis and Lung Disease, 19(7), 764–771. https://doi.org/10.5588/ijtld.14.0767.

[23].  Malede, A., Shibabaw, A., Hailemeskel, E., Belay, M., & Asrade, S. (2015). Treatment Outcome of Tuberculosis Patients and Associated Risk Factors at Dessie and Woldiya Town Health Institutions, Northeast Ethiopia: A Retrospective Cross-Sectional Study. https://doi.org/10.4172/2155-9597.1000240.

[24].  Ofoegbu, O. S., & Odume, B. B. (2015). Treatment outcome of tuberculosis patients at National Hospital Abuja Nigeria: a five-year retrospective study. South African Family Practice, 57(1), 50–56. https://doi.org/10.1080/20786190.2014.995913.

[25].  Oshi, D. C., Oshi, S. N., Alobu, I., & Ukwaja, K. N. (2014). Profile and treatment outcomes of tuberculosis in the elderly in southeastern Nigeria, 2011-2012. PLoS ONE, 9(11), 2011–2012. https://doi.org/10.1371/journal.pone.0111910.

[26].  Santha, T., Garg, R., Frieden, T. R., Chandrasekaran, V., Subramani, R., Gopi, P. G., … Narayanan, P. R. (2002). Risk factors associated with default, failure and death among tuberculosis patients treated in a DOTS programme in Tiruvallur District, South India, 2000. International Journal of Tuberculosis and Lung Disease, 6(9), 780–788.

[27].  Sengul, A., Akturk, U. A., Aydemir, Y., Kaya, N., Kocak, N. D., & Tasolar, F. T. (2015). Factors affecting successful treatment outcomes in pulmonary tuberculosis: A single-center experience in Turkey, 2005-2011. Journal of Infection in Developing Countries, 9(8), 821–828. https://doi.org/10.3855/jidc.5925.

[28].  Tafess, K., Beyen, T. K., Abera, A., Tasew, G., Mekit, S., Sisay, S., … Siu, G. K. H. (2018). Treatment Outcomes of Tuberculosis at Asella Teaching Hospital, Ethiopia: Ten Years’ Retrospective Aggregated Data. Frontiers in Medicine, 5, 38. https://doi.org/10.3389/fmed.2018.00038.

[29].  Teshome Kefale, A., & Anagaw, Y. (2017). Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia. International Journal of General Medicine, Volume 10, 161–169. https://doi.org/10.2147/IJGM.S135305.

[30].  Treatment of tuberculosis. (n.d.).

[31].  Tuberculosis, G. (2018). Report 2018.

[32].  WHO. (2016). Global Tuberculosis Report 2016. Cdc 2016, (Global TB Report 2016), 214. https://doi.org/ISBN 978 92 4 156539 4.

[33].  Yadeta, D., Alemseged, F., & Biadgilign, S. (2013). Provider-initiated HIV testing and counseling among tuberculosis patients in a hospital in the Oromia region of Ethiopia. Journal of Infection and Public Health, 6(3), 222–229. https://doi.org/10.1016/j.jiph.2013.01.002.

[34].  Yakob, B., Alemseged, F., Paulos, W., & Badacho, A. S. (2018). Trends in Treatment Success Rate and Associated Factors among Tuberculosis Patients in Ethiopia: A Retrospective Cohort Study. Health Science Journal, 12(5). https://doi.org/10.21767/1791-809X.1000598.

[35].  Yen, Y.-F., Yen, M.-Y., Shih, H.-C., & Deng, C.-Y. (2012). Risk factors for unfavorable outcome of pulmonary tuberculosis in adults in Taipei, Taiwan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 106(5), 303–308. https://doi.org/10.1016/j.trstmh.2012.01.011.