Determinants of Successful Tuberculosis Treatment Outcome in a State University Teaching Hospital in South East, Nigeria: A 5 Year Retrospective Study

Abstract

Aim: The 2018 World Health Organization Global Tuberculosis Report enlisted Nigeria as one of the seven countries worldwide that accounted for 64% of all new cases of tuberculosis. The aim of this study was to assess the magnitude and determinants of tuberculosis treatment outcomes at a Tertiary Hospital in South East, Nigeria. Study Design: Retrospective cohort. Place and Duration: The Enugu State University Teaching Hospital Directly Observed Treatment Center, between April 2009 and March 2013. Methods: Completely filled data were extracted from tuberculosis treatment cards and registers of 445 clients (255 males, 190 females; age range 0-90 years) who assessed care at the DOTS clinic.  Tuberculosis treatment success outcome is defined as cured or completed TB treatment. Results: Of 445 registered patients, majority was males (57.3%), lived in urban areas (68.1%), and were newly diagnosed (97.8%). Of the 93.7% with pulmonary tuberculosis, 62% were smear negatives cases (62%). While the male to female ratio of the clients was 1.3:1, their mean age was 42 ± 16.7 years. About half (50.6%) had chest x-ray findings that were not diagnostic of Tuberculosis. While TB/HIV co-infection rate was 32.8%; 16% and 19.3% had commenced anti -retroviral and co-trimoxazole preventive treatment respectively. Treatment success was reported in 67.9% of all clients and was associated with being older than 14 year (AOR=12.0, 95% CI: 2.5 – 58.0) and having positive chest findings (AOR = 2.6, 95% CI: 0.3-0.6). Conclusions: The TB success rate in was 67.9% Being older than 14 years, having PTB and positive chest x ray findings were the predictors of good treatment outcome in this study. There is an urgent need to track and report the treatment outcome of patients who are lost to follow up since they constitute 20% of missed cases in this center.