Treatment outcome of tuberculosis patients at Gondar University Teaching Hospital, Northwest Ethiopia. A five - year retrospective study

Abstract

<p>Abstract</p> <p>Background</p> <p>In Gondar University Teaching Hospital standardized tuberculosis prevention and control programme, incorporating Directly Observed Treatment, Short Course (DOTS) started in 2000. According to the proposal of World Health Organization (WHO), treatment outcome is an important indicator of tuberculosis control programs. This study investigated the outcome of tuberculosis treatment at Gondar University Teaching Hospital in Northwest Ethiopia.</p> <p>Methods</p> <p>We analyzed the records of 4000 tuberculosis patients registered at Gondar University Teaching Hospital from September 2003 to May 2008. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Multivariate analysis using logistic regression model was used to analyse the association between treatment outcome and potential predictor variables.</p> <p>Results</p> <p>From the total of 4000 patients, tuberculosis type was categorized as extrapulmonary in 1133 (28.3%), smear negative pulmonary tuberculosis in 2196 (54.9%) and smear positive pulmonary tuberculosis in 671 (16.8%) cases. Of all patients, treatment outcome was classified as successfully treated in 1181(29.5%), defaulted in 730 (18.3%), died in 403 (10.1%), treatment failed in six (0.2%) and transferred out in 1680 (42.0%) patients. Males had the trend to be more likely to experience death or default than females, and the elderly were more likely to die than younger. The proportion of default rate was increased across the years from 97(9.2%) to 228(42.9%). Being female, age group 15-24 years, smear positive pulmonary tuberculosis and being urban resident were associated with higher treatment success rate.</p> <p>Conclusion</p> <p>The treatment success rate of tuberculosis patients was unsatisfactorily low (29.5%). A high proportion of patients died (10.1%) or defaulted (18.3%), which is a serious public health concern that needs to be addressed urgently.</p

Treatment Outcome of Tuberculosis Patients in Azezo Health Center, North West Ethiopia

“…High death rate, 16.3%, was observed among individuals with age >55 years which is in line with a study conducted previously in Gondar with a death rate of 15.8% 14 and a study elsewhere in the world 22 . Partly due to the increasing co morbidities and general deterioration with age high age has been reported to be a risk factor for death in TB patients [23][24][25] .…”

“…The default rate (1.7) and death rates (8.5%) found in this study were lower than that reported by Tessema, et al 14 but the death rate of the current report is higher than the report from Tigray region 15 . High death rate, 16.3%, was observed among individuals with age >55 years which is in line with a study conducted previously in Gondar with a death rate of 15.8% 14 and a study elsewhere in the world 22 .…”

“…This is also supported by a report from Tanzania where community based DOTS showed higher successful treatment outcome rate 21 . But the results of this study was higher than previous studies conducted in Gondar 14 and Southern region 18 which reported 29.5% and 74.8% successful treatment outcome respectively. Increased successful treatment outcomes observed in this study may be contributed by the establishment of the health center near to the residence of the patients and the difference in study settings.…”

“…Monitoring the outcome of treatment is essential in order to evaluate the effectiveness of DOTS program and serves as a proxy of quality of TB treatment in a health care system 14,15 . In addition to this understanding the reasons for unsuccessful treatment outcomes is of paramount importance so as to improve the system 16 .…”

Understanding the Tuberculosis Disease Progression and Future Directions of Research in Tuberculosis: A Mini Review

“…HIV co-infection is the strongest known risk factor for progression of LTBI to active TB disease (Lai et al 2016). Although HIV co-infection does not affect the success or failure rate of TB treatment (Tessema et al 2009), infection of TB in HIV co-infected patients may accelerate the progression of HIV disease. Previously, a MDR-TB contact study has demonstrated children less than 3 years old, HIV positive, exposed to MDR-TB source and poor socioeconomic factor had higher risk for TB infection (Seddon et al 2013).…”