Contributory Factors to Successful Tuberculosis Treatment in Southwest Nigeria: A Cross-Sectional Study

Abstract

Tuberculosis (TB) is one of the oldest human diseases, and preventing treatment failure is critical. This is because TB cases pose a risk to the immediate and remote communities due to the potential for spread, particularly for multidrug-resistant (MDR) strains that have been associated with higher morbidity and mortality rates. Hence, this study looked at the factors that influence TB treatment outcomes in Southwest Nigeria. We conducted a cross-sectional study with 712 TB patients from 25 directly observed treatment short course (DOTS) centers, out of which 566 (79.49%) were new treatment cases, and 102 (14.33%) were retreatment cases. The outcome variable was computed into successful treatment where ‘Yes’ was assigned to TB treatment completed and cured, and ‘No’ was assigned to all the remaining outcomes following the standard TB definition. Independent variables included in the analysis were the patient’s socio-demographic characteristics (such as age, sex, distance from the facility, marital status, family type, education, and computed socioeconomic status from modified DHS household assets), clinical and facility parameters (such as the HIV status, facility of access to healthcare, healthcare workers attitudes, services offered at the facility, appearance of the facility, number of people seeking care and waiting time at the facility). Bivariate analysis showed that HIV status (OR: 3.53, 95% CI: 1.83–6.82; p = 0.001), healthcare worker attitude (OR: 2.13, 95% CI: 1.21–3.74; p = 0.01), services offered at the facility (OR: 0.67, 95% CI: 0.49–0.92; p = 0.01), appearance of facility (OR: 0.67, 95% CI: 0.46–0.98; p = 0.04), and number of people seeking care (OR: 2.47, 95% CI: 1.72–3.55; p = 0.001) were associated with higher odds of successful treatment outcome with statistical significance. After multivariate analysis, reactive HIV status (aOR: 3.37, 95% CI: 1.67–6.80; p = 0.001), positive attitude of healthcare workers (aOR: 2.58, 95% CI: 1.36–4.89; p = 0.04), excellent services offered at the healthcare facility (aOR: 0.53, 95% CI: 0.36–0.78; p = 0.001) and few people seeking care (aOR: 2.10, 95% CI: 1.21–3.84; p = 0.001) became independent significant determinants of successful treatment outcome. The study concluded that reactive HIV status, positive attitude of healthcare workers, few people seeking healthcare, and excellent service provided were all factors that contributed to successful treatment outcomes.

Determinant of Successful Tuberculosis Treatment in Puskesmas Singosari in 2020-2022

“…Based on the results of bivariate analysis, the variable of age does not have a significant relationship with the success of TB treatment (p=0.165). These findings are consistent with the results of a study conducted in Nigeria, which also demonstrated that age groups do not have a significant relationship with the success of TB treatment [18]. It's similar to the findings of a previous study conducted at RSUD Ungaran in Kabupaten Semarang, which indicated that the age of TB patients did not have a significant relationship with the duration of treatment for TB category I until recovery [19].…”

“…It's similar to the findings of a previous study conducted at RSUD Ungaran in Kabupaten Semarang, which indicated that the age of TB patients did not have a significant relationship with the duration of treatment for TB category I until recovery [19]. Previous studies have indicated a similar pattern among TB patients, with the highest burden observed in the age groups ranging from young to middle-aged individuals [18]. The Drug-Susceptible TB patients who became the samples in this study were predominantly in the age group of 15-44 years, and the highest percentage of successful TB treatment was found in the age group of 15-44 years (95.2%).…”

Environmental factors determine the occurrence of pulmonary tuberculosis

“…Cases of pulmonary TB in people with diabetes mellitus comorbidity have never been found (8). Pulmonary TB is transmitted through the air (9) when the patient sprinkles mucus or phlegm when coughing or s n e e z i n g ( 1 0 ) . D u r i n g t h i s t i m e , t h e t u b e r c u l o s i s -c a u s i n g b a c t e r i a , mycobacterium tuberculosis, also come out through the mucus and were carried into the air (11).…”