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Tuberculosis Treatment Outcomes and Interruption among Patients Assessing Dots Regimen in a Tertiary Hospital in Semi-Urban Area of South-Western Nigeria
Abstract
Background
Tuberculosis remains one of the most infectious diseases worldwide especially with the HIV pandemic. It is a cause of high morbidity and
mortality in developing countries including Nigeria. Reasons contributing to high morbidity and mortality include high defaulting rate and treatment interruption. Several studies had evaluated the treatment outcome of tuberculosis but there is paucity of published literature on the outcome of treatment interruption especially in this environment. This study thus assessed the outcome of treatments and interruption among patients assessing DOTS regimen in a tertiary hospital located in a semi urban area in south-western Nigeria.
Methodology
The study was a review of TB register of the federal medical centre,Owo from its inception in 2008 to 2011. All the patients that have completed at least one course of chemotherapy (defined as 8 months of anti-tuberculosis treatment- 2months intensive phase and 6 months continuation phase) were included. Treatment outcome and interruption were defined in accordance with World Health Organisation (WHO) recommendations. Data were analysed with SPSS version 17.
Results
A total of 400 patients were included. The mean age of patients was 36.8 ± 16.8 years and 56.3% were male. Majority, (79.7%) were adults aged 19-64 years, 12.5% were in the paediatric age group and 7.8% were elderly. Less than half, 45.3% had TB/HIV co-infection. Regarding treatment outcome of tuberculosis, 75.5% were cured, 14.8% died, 4% relapsed and 3% defaulted. A little above one-fifth, 21 (5.3%) had
treatment interruption among whom 9 (42.9%) were successfully traced and completed treatment. Significantly, higher proportion of those that had treatment interruption died, 54.1% compared with their counterpart, 14.9%, (p<0.001) and had relapse. (14.3% versus 3.4%, p = 0.01).
Conclusion
A high rate of tracking failure among patients with treatment interruption was found in the study. In addition, mortality and morbidity were higher among patients with treatment interruption. A more concerted effort is needed in tracking / tracing patients with treatment interruption in order to reduce morbidity and mortality among TB patients assessing treatment.
Tuberculosis remains one of the most infectious diseases worldwide especially with the HIV pandemic. It is a cause of high morbidity and
mortality in developing countries including Nigeria. Reasons contributing to high morbidity and mortality include high defaulting rate and treatment interruption. Several studies had evaluated the treatment outcome of tuberculosis but there is paucity of published literature on the outcome of treatment interruption especially in this environment. This study thus assessed the outcome of treatments and interruption among patients assessing DOTS regimen in a tertiary hospital located in a semi urban area in south-western Nigeria.
Methodology
The study was a review of TB register of the federal medical centre,Owo from its inception in 2008 to 2011. All the patients that have completed at least one course of chemotherapy (defined as 8 months of anti-tuberculosis treatment- 2months intensive phase and 6 months continuation phase) were included. Treatment outcome and interruption were defined in accordance with World Health Organisation (WHO) recommendations. Data were analysed with SPSS version 17.
Results
A total of 400 patients were included. The mean age of patients was 36.8 ± 16.8 years and 56.3% were male. Majority, (79.7%) were adults aged 19-64 years, 12.5% were in the paediatric age group and 7.8% were elderly. Less than half, 45.3% had TB/HIV co-infection. Regarding treatment outcome of tuberculosis, 75.5% were cured, 14.8% died, 4% relapsed and 3% defaulted. A little above one-fifth, 21 (5.3%) had
treatment interruption among whom 9 (42.9%) were successfully traced and completed treatment. Significantly, higher proportion of those that had treatment interruption died, 54.1% compared with their counterpart, 14.9%, (p<0.001) and had relapse. (14.3% versus 3.4%, p = 0.01).
Conclusion
A high rate of tracking failure among patients with treatment interruption was found in the study. In addition, mortality and morbidity were higher among patients with treatment interruption. A more concerted effort is needed in tracking / tracing patients with treatment interruption in order to reduce morbidity and mortality among TB patients assessing treatment.
