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

Abstract

An essential metric for determining the efficacy of tuberculosis (TB) control programs is the evaluation of TB treatment outcomes; this study was conducted to investigate treatment outcomes and associated factors among tuberculosis patients in rural areas of Eastern Cape, South Africa. Assessing treatment outcomes is fundamental to facilitating the End TB Strategy’s set target. Clinic records from 457 patients with DR-TB were examined for data collection while 101 patients were followed up prospectively. Data were analyzed using Stata version 17.0. The odds ratio and 95% confidence interval were calculated to check the association between variables. p ≤ 0.05 was considered statistically significant. Of the 427 participants, 65.8% had successful treatment whilst 34.2% had unsuccessful TB treatment. A total of 61.2% and 39% of the HIV-positive and HIV-negative participants had a successful TB treatment whilst 66% and 34% of both HIV-negative and positive participants had unsuccessful TB treatment. From the 101 patients that were followed up, smokers took longer to have treatment outcomes compared to non-smokers. In the study with HIV/TB co-infection, men predominated. HIV and tuberculosis co-infection made therapy difficult with unfavorable effects on TB management. The treatment success rate (65.8%) was lower than the WHO threshold standard with a high proportion of patients being lost to the follow up. The co-infection of tuberculosis and HIV resulted in undesirable treatment outcomes. Strengthening TB surveillance and control is recommended.

Practical Recommendation of Mapping a Model for Collaboration of Health Care Facilities, Diagnostic Laboratories, and Research Institutions: Management of Drug Resistant Tuberculosis in Rural Eastern Cape

“…Our research on the treatment outcomes and related factors among tuberculosis patients involved examining the clinic records of 457 patients with DR-TB using the ambidirectional method. In addition, we followed up with 101 patients prospectively until the completion of their treatment, as detailed in our published manuscript [15]. The collected data included socio-demographics, clinical information, and treatment outcomes, which we analyzed using Stata version 17.0, as presented in Table 1, Table 2, Table 3, and Table 4, along with Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, Figure 6, and Figure 7 from our published manuscript [15].…”

“…In addition, we followed up with 101 patients prospectively until the completion of their treatment, as detailed in our published manuscript [15]. The collected data included socio-demographics, clinical information, and treatment outcomes, which we analyzed using Stata version 17.0, as presented in Table 1, Table 2, Table 3, and Table 4, along with Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, Figure 6, and Figure 7 from our published manuscript [15]. We calculated the odds ratio and 95% confidence interval to assess the association between variables.…”

“…We calculated the odds ratio and 95% confidence interval to assess the association between variables. A p-value of 0.05 or less was considered statistically significant [15].…”

“…The co-infection of TB and HIV is a major public health problem in many parts of the world, particularly in resource-limited countries like South Africa. According to Faye et al [15], the rate of co-infection was high in rural areas of Eastern Cape, with men being mostly affected, leading to poor treatment outcomes. It has been established that the double burden of TB and HIV is a significant global health challenge [28,29,30].…”

“…The success rate of TB treatment was lower than the WHO threshold standard at 65.8% due to a high number of patients being lost during follow-up. The co-infection of TB and HIV has resulted in poor treatment outcomes in rural areas of the Eastern Cape [15]. INH is one of the most efficient and targeted medications for treating the disease caused by M. tuberculosis.…”