Factors influencing treatment outcomes of tuberculosis patients attending health facilities in Galkayo Puntland, Somalia

Abstract

Aim This study evaluated the underlying factors associated with poor tuberculosis (TB) treatment outcomes among patients attending health care facilities in Galkayo, Puntland, Somalia. Methods An institution-based cross-sectional study was conducted between 2016 and 2017 in three selected TB clinics. Data were collected from 400 TB patients, through medical record review and structured questionnaire. Multivariate logistic regression analyses were performed. Results Of the 400 TB respondents, 57.3% were new cases, 12.3% had smear-negative TB and 12.5% had extrapulmonary TB. The median age was (35.66 ± 13.16) with majority being male (65.5%). Overall, 85% of patients were successfully treated, 9.7% failed and 5.3% defaulted. Multivariate analysis revealed that patient’s body weight (odds ratio [OR]: 1.078); diabetes (OR: 8.022); family size (OR: 3.851); patients’ delay in diagnosis (OR: 11.946); frequency of receiving anti-TB medication (OR: 9.068); smoker (OR: 5.723); category of patients (retreatment versus new, OR: 5.504; retreatment versus transfer in, OR: 4.957); health facilities (OR: 6.716) and treatment duration (OR: 132.091) were independent factors associated with poor TB outcomes. Conclusions Our findings highlight the need to improve TB services for vulnerable groups. They also emphasize the need for health system strengthening, public awareness and risk of treatment interruption. This may reduce both patients’ delay in seeking care and TB treatment failure in Galkayo district.

Tuberculosis treatment outcomes and associated factors among tuberculosis patients treated at healthcare facilities of Motta Town, Northwest Ethiopia: a five-year retrospective study

“…This result is higher than the studies conducted in Ghana (68.46%) 35 , North-Central Nigeria (67.4%) 36 , Somalia (85%) 15 , Wolayta Sodo, Southern Ethiopia (82.5%) 26 , Woldia, Northeast Ethiopia (80.7%) 24 , Adama City, Ethiopia (80.8%) 37 , Asella, Ethiopia (81.7%) 21 , Gambella, Southwest Ethiopia (70.76%) 38 , West Ethiopia (82.5%) 39 , Gedeo Zone, Southern Ethiopia (66.44%) 40 , Addis Abeba (82.7%) 13 , Ethiopian University Hospitals (60.1%) 41 , Dessie and Woldiya Town, Northeast Ethiopia (88.1%) 42 , and Debre Markos, Northwest Ethiopia (59.3%) 43 . Differences in sociodemographic characteristics, cultural practices, and socioeconomic status among these regions may contribute to variations in treatment outcomes.…”

“…Factors affecting TB outcomes are crucial indicators of TB control program success. Prompt initiation and adherence to national TB treatment standards are essential for effective therapy 15 . Monitoring the proportion of patients who receive successful treatment is key in evaluating the TB DOT program, particularly for those with TB and HIV co-infections due to potential treatment variables 6 .…”

Is Tobacco Use Associated With Risk of Recurrence and Mortality Among People With TB?

“…26 , 42 , 52 , 57 , 62 , 74 , 82 , 93 , 119 , 123 , 126 , 138 So-called unsuccessful treatment, which combined any outcome other than cure or completion of treatment, was reported in 28 studies. 24 , 49 , 60 , 61 , 65 , 68 , 71 , 73 , 78 , 80 , 85 , 87 , 90 , 91 , 94 , 95 , 104 , 107 , 108 , 114 , 117 , 122 , 123 , 126 , 137 , 140 , 145 , 146 Of these, the risk could not be extracted from four studies, 24 , 49 , 61 , 137 whereas most of the remaining ones reported increased risk, including three studies that included the use of ST products. 91 , 104 , 122 …”

Diabetes mellitus is associated with an increased risk of unsuccessful treatment outcomes among drug-susceptible tuberculosis patients in Ethiopia: A prospective health facility-based study

“…In another study from Tanzania, diabetes was associated with a fivefold increased risk of mortality (RR = 5.0, 95% CI 2.4–11.0) during the intensive phase of TB treatment [27] . A cross-sectional study from Somalia reported that the odds of poor TB outcomes among patients diagnosed with diabetes was eight-times higher that TB patients without diabetes (OR: 8.02 (1.79–35.86) [28] . Similarly, a case–control study from Egypt reported more than a nine-fold increased risk of treatment failure (RR = 9.32 (2.7–31.69) among patients with TB and diabetes compared to those without diabetes [29] .…”