Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital, northwest Ethiopia: nine-years retrospective study

Abstract

Background: Data regarding tuberculosis (TB) treatment outcomes, proportion of TB/HIV co-infection and associated factors have been released at different TB treatment facilities in Ethiopia and elsewhere in the world as part of the auditing and surveillance service. However, these data are missing for the TB clinic offering directly observed treatment short-course (DOTs) at Debre Tabor General Hospital (DTGH). Methods: The authors analysed the records of 985 TB patients registered at the DTGH from September 2008 to December 2016. Data on patients' sex, age, type of TB, and treatment outcomes were extracted from the TB treatment registration logbook. The treatment outcome of patients was categorized according to the National TB and Leprosy Control Program guidelines: cured, treatment completed, treatment failed, died, and not evaluated (transferred out and unknown cases). Results: Around half of the registered patients were males (516, 52.4%). In terms of TB types, 381 (38.7%), 241 (24.5%), and 363 (36.9%) patients had smear-negative pulmonary TB, smear-positive pulmonary TB, and extra pulmonary TB, respectively. Six hundred and seventy-two patients (90.1%) had successful treatment outcomes (cured and treatment completed), while 74 patients (9.9%) had unsuccessful treatment outcomes (death and treatment failure).TB treatment outcome was not associated with age, sex, type and history of TB, or co-infection with HIV (P > 0.05). The proportion of TB/HIV co-infection was at 24.2%, and these were found to be significantly associated with the age groups of 25-34, 35-44 and ≥65 years:(aOR: 0.44; 95% CI: 0.25-0.8), (aOR: 0.39; 95% CI: 0.20-0.70), (aOR: 4.2; 95% CI: 1.30-12.9), respectively. Conclusions: The proportion of patients with successful treatment outcomes was above the World Health Organization target set for Millennium Development Goal of 85% and in line with that of the global milestone target set at > 90% for 2025. Relatively higher proportions of transfer-out cases were recorded in the present study. Similarly, the proportion of TB/HIV co-infection cases was much higher than the national average of 8%.Thus, the health facility under study should develop strategies to record the final treatment outcome of transfer-out cases. In addition, strategies to reduce the burden of TB/HIV co-infection should be strengthened.

Trends of Mycobacterium Tuberculosis and Rifampicin resistance in Adigrat General Hospital, Eastern zone, Tigray Region, Northern Ethiopia

“…This finding was supported by previous studies conducted in Amhara (27.7%) [26], in Ethiopia (29.4%) [27], & in Central Nigeria (36.3%) [28]. However, our findings were higher than studies conducted in the Debre Markos Referral Hospital (16.6%) [13], different studies across Ethiopia (20.3-24.2 %) [14,[29][30][31][32], and a WHO estimation for Ethiopia of 14% (9.6%-19%) [2]. Conversely, the findings were lower than studies conducted in the FelegeHiwot Referral Hospital and Debre Tabor Hospital (41.9%) [20], Zambia (98.3%) [33] & South Africa (>70%) [34].…”

Trends of Mycobacterium Tuberculosis and rifampicin resistance in Adigrat General Hospital, Eastern Zone of Tigrai, North Ethiopia

“…This nding was supported by previous studies conducted in Amhara (27.7%) [26], Gambella [46], in Ethiopia (29.4%) [27], and in Central Nigeria (36.3%) [28]. However, our ndings were higher than studies conducted in the Debre Markos Referral Hospital (16.6%) [13], different studies across Ethiopia (20.3-24.2 %) [14,[29][30][31][32], and a WHO estimation for Ethiopia of 14% (9.6%-19%) [2]. Conversely, the ndings were lower than studies conducted in the Felege Hiwot Referral Hospital and Debre Tabor Hospital (41.9%) [20], Zambia (98.3%) [33], and South Africa (>70%) [34].…”

Explaining the successes and failures of tuberculosis treatment programs; a tale of two regions in rural Eastern Uganda

“…The between country variation is seen from TSR of 83.4% in Cameroon, (6) 90.1% in Ethiopia (7), and 75.7% in Nigeria. (8) Uganda is an example of a country with significant within-country TSR variation.…”