Treatment outcomes among adult drug sensitive pulmonary tuberculosis patients in a private tertiary hospital in Ogun State, Nigeria: a retrospective study

Abstract

Department of Community Medicine1
, Babcock University Teaching Hospital,
Ilishan-Remo, and Department of Community Medicine and Primary Care2
,
Federal Medical Centre, Abeokuta, Ogun State, Nigeria
Abstract
Background: Tuberculosis (TB) remains a high burden disease particularly in developing countries. The periodic
appraisal of the outcome of treatment and associated determinants is of utmost value, as it serves as a litmus test
of the impact of the TB control programme in the facility and its catchment area. This study thus aimed to review
treatment outcomes and associated factors among drug sensitive pulmonary TB patients accessing care in a
private tertiary hospital in Ogun State, Nigeria.
Methods: A retrospective review of 171 drug sensitive pulmonary TB patients managed from January 2013 to
December 2020 at the TB (DOTS) clinic of Babcock University Teaching Hospital (BUTH) was done. The
socio-demographic, clinical, and laboratory data were extracted from the presumptive TB register. The analysis
was done using SPSS version 20. Relevant descriptive and inferential statistics were calculated with the level of
significance set at p< 0.05.
Results: The mean age of the drug sensitive pulmonary TB patients was 42.11±14.86 years. More than half
(51.5%) of them were females, while 48.5% were males. About two-fifth (38.6%) of the patients were classified
as completed treatment, 35.7% achieved cure, 7.0% were lost to follow up, 0.6% had treatment failure and
18.1% died. Overall, 75.4% of the patients had treatment success while 24.6% had unsuccessful treatment. Those
who were HIV negative had a statistically significantly better treatment outcome as compared to those who were
HIV positive (p=0.03). There was also a statistically significant association between usage of HAART and
treatment outcomes (p=0.002).
Conclusion: The findings on better TB treatment outcomes among HIV negative patients and HIV positive
patients on HAART highlight the need for HIV prevention strategies and sustainable provision of HAART
during the management of TB.
Keywords: BUTH, HAART, HIV, Ogun State, Treatment Outcome, TB.
Résumé
Contexte: La tuberculose (TB) reste une maladie à charge élevée, en particulier dans les pays en développement.
L’évaluation périodique des résultats du traitement et des déterminants associés est de la plus haute valeur, car
elle sert de test décisif de l’impact du programme de lutte antituberculeuse dans l’établissement et sa zone de
desserte. Cette étude visait donc à examiner les résultats du traitement et les facteurs associés chez les patients
atteints de tuberculose pulmonaire sensible aux médicaments accédant aux soins dans un hôpital tertiaire privé
de l’État d’Ogun, au Nigéria.
Méthodes: Une revue rétrospective de 171 patients atteints de tuberculose pulmonaire sensible aux médicaments
pris en charge de janvier 2013 à décembre 2020 à la clinique TB (DOTS) du Babcock University Teaching
Hospital (BUTH) a été réalisée. Les données sociodémographiques, cliniques et de laboratoire ont été extraites
du registre présomptif de la tuberculose. L’analyse a été effectuée à l’aide de la version 20 de SPSS. Les
statistiques descriptives et inférentielles pertinentes ont été calculées avec le niveau de signification fixé à p
<0,05.
Résultats: L’âge moyen des patients tuberculeux pulmonaires sensibles aux médicaments était de 42,11 ± 14,86 ans. Plus de la moitié
(51,5%) d’entre eux étaient des femmes, tandis que 48,5% étaient des hommes. Environ deux cinquièmes (38,6%) des patients ont été
classés comme traitement terminé, 35,7% ont guéri, 7,0% ont été perdus de vue, 0,6% ont échoué au traitement et 18,1% sont décédés.
Dans l’ensemble, 75,4% des patients ont eu un succès de traitement tandis que 24,6% ont eu un traitement infructueux. Ceux qui étaient
séronégatifs avaient des résultats de traitement statistiquement significativement meilleurs que ceux qui étaient séropositifs (p = 0,03). Il
y avait également une association statistiquement significative entre l’utilisation du HAART et les résultats du traitement (p = 0,002).Conclusion: Les résultats sur de meilleurs résultats du traitement de la tuberculose chez les patients séronégatifs
et les patients séropositifs sous HAART soulignent la nécessité de stratégies de prévention du VIH et de
fourniture durable de HAART pendant la prise en charge de la tuberculose.
Mots clés: BUTH, HAART, VIH, état d’Ogun, résultat du traitement, tuberculose.
Correspondence: Dr. K.O. Ogunyemi, Department of Community Medicine, Babcock University Teaching Hospital,
Ilishan-Remo, Ogun State, Nigeria. E-mail: ogunyemik@babcock.edu.n

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References

WHO. Tuberculosis. Available at: https://www.who.int/westernpacific/health-topics/tubercuosis. Accessed Dec 2, 2020.

Ogbo FA, Ogeleka P, Okoro A, et al. Tuberculosis disease burden and attributable risk factors in Nigeria, 1990-2016. Trop Med Health. 2018; 46.

National Agency for the Control of AIDS (NACA) Nigeria. Nigeria Prevalence Rate. Available at: https://naca.gov.ng/nigeria-prevalence-rate/. Accessed Dec 6, 2020.

WHO/TB comorbidities and risk factors. Available at: https://www.who.int/tb/areas-of-work/treatment/risk-factors/en/. Accessed Dec 6, 2020.

National TB and Leprosy Control Programme. Available at: https://ntblcp.org.ng/about-us. Accessed Dec 2, 2020.

Federal Ministry of Health. End TB: Module for Training Health Care Workers in the Public and Private Sectors for the management and Care of Tuberculosis. 1st Edition. 2019.

WHO. “Global Tuberculosis Report. 2017. Available at: https://www.who.int/tb/publications/global_report/gtbr2017_main_text.pdf?u%20a=1. Accessed Dec 6, 2020.

Biruk M, Yimam B, Abrha H, Biruk S, and Amdie FZ. Treatment outcomes of tuberculosis and associated factors in an Ethiopian university hospital. Advances in Public Health. 2016; 8504629.

Nakanwagi-Mukwaya A, Reid AJ, Fujiwara PI, et al. Characteristics and treatment outcomes of tuberculosis retreatment cases in three regional hospitals, Uganda Public Health Action. 2013 Jun 21;3(2):149–155

Babatunde OA, Elegbede OE, Ayodele FM, et al. Factors Affecting Treatment Outcomes Of Tuberculosis In A Tertiary Health Center In Southwestern Nigeria International Review of Social Sciences and Humanities 2013;4(2):209-218.

Oshi SN, Alobu I, Ukwaja KN, and Oshi DC. Investigating gender disparities in the profile and treatment outcomes of tuberculosis in Ebonyi state, Nigeria. Epid& Infect. 2015; 143(5):932–942.

Fatiregun AA, Ojo AS and Bamgboye AE. Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria. Ann Afr Med. 2009; 8 (2):100-104.

Sariem CN, Odumosu P, Dapar MP, et al. Tuberculosis treatment outcomes: a fifteen-year retrospective study in Jos-North and Mangu, Plateau State, North-Central Nigeria. BMC Public Health. 2020; 20 (1):1224.

Mohammed T, Daniel K, Helamo D and Leta T. Treatment outcomes of TB patients in nigistEleni Mohammed general hospital, hosanna southern nations, nationalities and people region, Ethiopia: a five year (June 2009 to August 2014) retrospective study. Arch Public Health. 2017; 75:16.

Getie A and Alemnew B. Tuberculosis treatment outcomes and associated factors among patients treated at Woldia General Hospital in Northeast Ethiopia: an institution-based cross-sectional study. Infect Drug Resist. 2020; 13:3423-3429.

Tesema T, Seyoum D and EjetaE,Tsegaye R. Determinants of tuberculosis treatment outcome under directly observed treatment short courses in Adama City, Ethiopia. PLoS One. 2020; 15 (4):e0232468.

Genet C, Melese A, Worede A. Effectiveness of directly observed short course therapy (DOTS) on treatment of tuberculosis patients in public health facilities of Debre Tabor Town, Ethiopia: a retrospective study. BMC Res Notes. 2019;12 (1):396.

Babcock University Teaching Hospital. Available at: https://www.babcock.edu.ng/buth. Accessed Dec 2, 2020.

Federal Ministry of Health. Department of Public Health. National Tuberculosis and Leprosy Control Programme. National Tuberculosis, Leprosy and Buruli Ulcer Management and Control Guidelines. 6th edition. 2014.

WHO. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: XpertMTB/RIF. Policy statement. 2011.

Berhe G, Enquselassie F, and Aseffa A. Treatment outcome of smear-positive pulmonary tuberculosis patients in Tigray Region, Northern Ethiopia. BMC Public Health.2012; 12(1).

Abdulkader M., van Aken I., Niguse S, Hailekiros H and Spigt M. Treatment outcomes and their trend among tuberculosis patients treated at peripheral health settings of Northern Ethiopia between 2009 and 2014: a registry-based retrospective analysis. BMC Res Notes. 2019;12:786.

Tadesse S and Tadesse T. Treatment success rate of tuberculosis patients in Dabat, Northwest Ethiopia. Health. 2014;6(5):306–310.

El Sharbrawi M and El-Shafei D. Evaluation of treatment failure outcome and its predictors among pulmonary tuberculosis patients in Sharkia Governorate, 2013–2014. Egyptian Journal of Chest Diseases and Tuberculosis. 2017;66(1):145-152

WHO. Tuberculosis Fact Sheet N0104: 2015. Available at: http://www.stoptb.org/assets/documents/global/plan/plan2/General%20TB%20Factsheet%20-%20November%202015%20final.pdf. Accessed Dec 2, 2020.

Mayer K. Synergistic Pandemics: Confronting global HIV and TB epidemics. Clinical Infectious disease 2010;50 (3):S67.

Suchindran S. Is HIV Infection a risk factor for MDR TB? A systematic review. PLoS One 2009;4 (5):e5561.

UNAIDS. Press release. Available at: https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2019/march/20190314_nigeria. Accessed Dec 3, 2020.

Nigeria TB death rate 1960-2019. Available at www.kodema.com. Accessed Jan 4, 2021.

dos Santos APG, Pacheco AG, Staviack A, et al. Safety and effectiveness of HAART in tuberculosis-HIV co-infected patients in Brazil. Int J Tuberc Lung Dis 2013;17(2):172-197

Harries AD, Zachariah R and Lawn SD. Providing HIV care for co-infected tuberculosis patients: a perspective from Sub-Saharan Africa. International Journal of Tuberculosis & Lung Disease 2009;13:6-16

WHO. Tuberculosis Fact Sheet 2020. Available at: www.who.int>Newsroom>Factsheets> Detail. Accessed Jan 4, 2021.

Tola A, Minshore KM, Ayele Y and Mekuria AN. Tuberculosis Treatment Outcomes and Associated Factors among TB Patients Attending Public Hospitals in Harar Town, Eastern Ethiopia: A Five-Year Retrospective Study. Tuberculosis Research and Treatment Vol 2019. Article ID 1503219.

Ogun State Nigeria Population Statistics Charts, Map, and Location. Available at https://www.citypopulation.de>php>nigeria. Accessed Jun 12, 2020.