Treatment outcome of directly observed therapy short-course for pulmonary tuberculosis patients in a Nigerian tertiary institution: An eight-year review

Abstract

Objective: Tuberculosis (TB) is a world-wide public health problem. Despite progress made in the treatment of the disease, TB remains a leading infectious cause of death among adults in Nigeria. Directly observed therapy short-course (DOTS) which was introduced by WHO have proved effective in TB treatment in some parts of Asia and Africa. The aim of this study was to evaluate the treatment outcome of DOTS among pulmonary TB patients in a tertiary institution in Nigeria.

Methods: A retrospective study of consecutive pulmonary TB patients that attended DOTS clinic in a Nigerian tertiary institution between January 2003 and December 2010. The research instrument was hospital records. Patients’ demographics were recorded. Diagnosis and treatment were according to the World Health Organization (WHO) recommendations. Cases detected, sputum conversion and treatment outcome reports were analyzed using percentage.

Results: A total of 177 pulmonary TB patients were seen during the eight-year period of this study. A male to female ratio of 1.6: 1 was observed and the 15 to 24 years age group were mostly affected (82 [46.3%]) followed by 25-34 age group (36 [32.2%]). New smear positive patients were 138 (78%) and smear negative 13 (7.3%). The sputum conversion smear positive cases were 121 (68.4%) whereas smear negative were 56 (31.6%). Out of the total number of 177 seen, 149 (84.2%) were cured. Treatment failed in 9 (5.1%) patients, 8 (4.5%) defaulted, 3 (1.7%) died before the completion of the treatment.

Conclusion: The clinic was able to meet the WHO recommendation of 70% case detection and just fell short of success rate of 85%. Effort therefore should be made to screen the students’ community every session in order to identify new cases and institute prompt treatment.

Keywords: Pulmonary tuberculosis, treatment outcome, directly observed therapy short course, tertiary institution, Nigeria