Drug-susceptible tuberculosis treatment outcomes and its associated factors among inmates in prison settings in Bauchi State, Nigeria, 2014–2018

Abstract

Tuberculosis (TB) is a contagious disease and its transmissibility is increased in congregate settings. TB incidence rates are five-to-fifty times higher among inmates in prison settings than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its associated factors in Nigerian prison settings. We therefore assessed TB treatment outcomes among inmates in prison settings in Bauchi State, Nigeria. We conducted a retrospective data analysis of inmates with TB in the five-main prison settings in Bauchi State. We extracted socio-demographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a checklist. We calculated the TB treatment success rate (TSR) and explored the relationship between the TSR and socio-demographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify factors associated with TSR at 5% level of significance. All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 65 (30.1%) were transferred-out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Factors associated with successful-treatment-outcome were age, weight, imprisonment duration and HIV status. The results indicate that inmates who are 20–29 years are at least ten times more likely to be successful (aOR = 10.5; 95%CI: 3.2–35.1) than inmates who are 55 years or older. Inmates who are 30–39 years are about four times more likely to be successful than inmates who are 55 years or older (aOR = 4.2; 95% CI: 1.3–13.1). In general, the younger an inmate, the more successful he is. Inmates with pretreatment-weight; 55kg or more are 13 times more likely to be successful (aOR = 13.3; 95%CI: 6.0–29.6) than inmates with weight below 55kg. Inmates who were imprisoned for 2 years or less are about three times more likely to be successful (aOR = 2.6; 95%CI: 1.3–5.4) than inmates who were imprisoned for more than 2 years and HIV negative inmates were three times more likely to succeed (aOR = 3.3; 95%CI:1.4–7.8) than inmates who were HIV positive. We recommended that to improve TB treatment outcome among inmates; age, duration-of-imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking-system be developed by the authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.

Treatment Outcomes and Associated Factors among Tuberculosis Patients from Selected Rural Eastern Cape Hospitals: An Ambidirectional Study

“…Treatment success rate (TSR) is a helpful measure for evaluating the efficacy of the tuberculosis control campaign. The implication of a low TSR is that TB-infected patients may not be receiving adequate treatment and stand the risk of developing drug-resistant TB which could serve as a potential reservoir for the transmission of MDR-TB [ 25 ]. Although the overall treatment success rate of 65.8% obtained in this study was lower compared to the 86% global average achieved in 2020 [ 26 ] and the 90% target advocated by WHO, this was higher than that of 57.4% in Kwazulu-Natal Province [ 1 ] but lower than that of 80% from Gauteng Province in South Africa [ 27 ].…”

Predictors of multidrug-resistant tuberculosis in a teaching hospital in Ghana: A case-control study

“…It occurs when the Mycobacterium strain becomes resistant to both Isoniazid (INH) and Rifampicin (RIF), the two powerful anti-TB drugs [4,5]. The management and treatment of MDR-TB are complex, and it is hard to achieve favourable treatment outcomes as compared to drug-sensitive TB, even under optimal circumstances [6][7][8]. The treatment is usually prolonged with a minimum duration of 24 months [9].…”