Trends of tuberculosis prevalence and treatment outcome in an under-resourced setting: The case of Enugu state, South East Nigeria

Abstract

Background:The burden of tuberculosis (TB) in Nigeria is high. Unfortunately, the data from the TB programme of the States’ ministries of health are usually unpublished, which possibly contribute to the prevailing ignorance and poor attitude of Nigerians to the disease. This study determined the trends of TB burden and treatment outcome in Enugu state, Nigeria; and relate the State's disease burden to that of the Nation.Materials and Methods:A descriptive study of secondary data from the TB control programme, Ministry of Health, Enugu state, the National annual report of 2008, and World Health Organisation (WHO) TB database for the 10-year period of 2000-2009.Results:The number of female TB cases was higher than males within the 0-14 age group only. The annual number of all TB cases showed a rising trend from 914 cases in the year 2000 to 1684 in 2009; but the proportion of new sputum smear (ss+) pulmonary tuberculosis (PTB) cases declined (Trend X2 = 7.37, P = 0.007). The average number of extra-pulmonary TB cases increased fourfold from 2000-2004 to 2005-2009 (36 versus 150 cases). The median treatment success rate was 82% (range: 78-85). For the period 2004-2008, 2.0% of all new ss + PBT cases reported in Nigeria, originated from Enugu state. The proportion of new ss + PTB reported in Enugu state was significantly higher than national value (59.6% versus 52.6%) [P < 0.001, OR = 1.33 (95% CI: 1.26, 1.40)].Conclusion:The burden of TB in Enugu state of Nigeria had increased over the period reviewed. However, the State's contribution to the disease burden in Nigeria was low.

Tuberculosis Treatment Outcomes and Determinants among Patients Treated in Hospitals in Imo State, Nigeria

“…Default rates, death rates, and failure rates of 9.8%, 6.5%, and 1.5% respectively were still within the national range [18]. It was also similar to what was obtained in Enugu state, Nigeria [49] and in a study from India [26]. This high default rate is of great concern due to its public health implication in spreading the disease and in the emergence of resistance strains of the TB organism.…”

“…Nevertheless, the treatment success found in this study was higher than figures reported in studies from, Nnewi, (61.3%) [19] Owo Ondo state, (75.5%) [51] Ibadan (76.6%) [17], Ebonyi state, (65.8%) [40], Abuja, (65.8%) [39] all from Nigeria and in Limpopo South Africa, (74.4%) [25]. Yet our findings compares favorably with the treatment successes reported in some other studies; 82% from a study in Enugu state [49], 80% in another study from Ebonyi state [56], 83.4% in India [26] and 82.7% in Addis Ababa, Ethiopia [23]. This variations in treatment success is likely to have been caused by various socio-demographic/economic factors, issues related to drug compliance and monitoring, nutritional status of individuals, the HIV pandemic, and drug susceptibility/resistance among others which varies greatly from place to place.…”

“…Several studies have reported similar pattern especially in developing countries [7] [49]. It has been postulated that due to their age factor and family economy depending on them, they involve themselves in earning and get exposed to other cases in the community [26].…”

Prevalence of Tuberculosis and Rifampicin Resistance Among Patients Seeking Medical Care in Nasarawa State, North Central Nigeria

“…The African Region had approximately one quarter of the world's cases, and the highest rates of cases and deaths relative to population, while India and China had the largest number of cases, 24% and 11% of the global total respectively [2]. Although the 2015 millennium development goal of halting and reversing the TB incidence has been achieved globally, in all six WHO regions and in most of the 22 high TB burden countries, and TB incidence fell at an average rate of about 1.5% per year between 2000 and 2013 [2], the burden of TB in Nigeria remains high [4]. Also, the burden of both TB and HIV infections in Nasarawa State, Nigeria is also relatively high while TB diagnostics are grossly inadequate [5].…”

Evaluation of acetylator phenotype of isoniazid among tuberculosis patients in delta state Nigeria: update on management of toxicity

“…1 A recent descriptive study of secondary data from a TB control programme showed that the annual number of all TB cases increased from 914 cases in the year 2000 to 1684 in 2009; and that while the proportion of new sputum smear diagnoses of pulmonary TB declined, extra-pulmonary TB cases increased by about four fold. 31 This is evidence that pulmonary TB as a clinical condition is being managed and monitored by the practitioners in the country. There is also a report that the Federal Ministry of Health has established ten reference laboratories and scaled up GeneXpert technology from 9 in 2011 to 52 in 2013 to enhance diagnosis of drug susceptible and drug resistant TB.…”