Tuberculosis treatment default in a large tertiary care hospital in urban Nigeria: Prevalence, trend, timing and predictors

Ifebunandu, Ngozi; Ukwaja, Kingsley Nnanna

doi:10.1016/j.jiph.2012.06.002

Cited by 33 publications

(46 citation statements)

References 10 publications

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“…This agrees with the results of previous studies conducted in both developed and developing countries (20,22,(28)(29)(30).…”

Section: Discussionsupporting

confidence: 93%

Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case-control study

Ali¹,

Prins²

2017

East Mediterr Health J

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Facteurs pathologiques et thérapeutiques entraînant un abandon du traitement de la tuberculose dans l'État de Khartoum, Soudan : étude cas-témoin RÉSUMÉ L'abandon du traitement de la tuberculose (TB) demeure un défi dans la lutte antituberculeuse. La présente étude cas-témoin avait pour objectif d'identifier les déterminants de l'abandon de traitement parmi les patients atteints de tuberculose pris en charge dans des centres de traitement dans l'État de Khartoum entre mai et juillet 2011. Les cas comprenaient des patients atteints de tuberculose et ayant abandonné leur traitement, et les témoins étaient ceux ayant mené leur traitement à terme. Sur les 2727 patients atteints de tuberculose traités dans les centres, 328 (14 %) avaient abandonné le traitement. Sur ce nombre, 185 avaient repris le traitement avant la collecte des données, et 143 étaient restés sans traitement et étaient donc éligibles comme cas. Sur les 143, 27 n'ont pu être tracés et 11 ont refusé de participer. Ainsi, 105 cas et 210 témoins ont été inclus et interrogés. Les variables associées de façon significative avec l'abandon de traitement étaient le fait d'habiter en zone rurale (OR = 2,68 ; IC à 95 % I 1,51-4,73), la non participation à un programme DOTS (traitement de brève durée sous surveillance directe) (OR = 2,53 ; IC à 95 % 1,49-4,30), le développement d'effets secondaires (OR = 1,94 ; IC à 95 % 1,14-3,29) et des antécédents de tuberculose (rechute, tuberculose multirésistante ou échec du traitement) (OR = 5,11 ; IC à 95 % 2,69-9,6). Une attention devrait être accordée à ces groupes à risque d'abandon de façon à encourager l'observance et la poursuite du traitement. ‫ضابطة‬ ‫حالة‬ ‫دراسة‬ ‫السودان:‬ ‫اخلرطوم،‬ ‫والية‬ ‫يف‬ ‫السل‬ ‫عالج‬ ‫عن‬ ‫التخلف‬ ‫إىل‬ ‫تؤدي‬ ‫التي‬ ‫والعالج‬ ‫باملرض‬ ‫املرتبطة‬ ‫العوامل‬

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“…This agrees with the results of previous studies conducted in both developed and developing countries (20,22,(28)(29)(30).…”

Section: Discussionsupporting

confidence: 93%

Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case-control study

Ali¹,

Prins²

2017

East Mediterr Health J

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“…In a Syrian Arab Republic study, after adjustment for confounders, male sex was found to be a significant risk factor for a negative treatment outcome (default, failure or death) with a 2.9-fold increased risk [29]. The same finding was reported in recent studies in Nigeria and Kenya [24, 26]. Specifically in Morocco, a recent study showed a higher risk of failure, default, or relapse within two years for male gender (OR = 2.29, 95% CI 1.10-4.77) [6].…”

Section: Discussionsupporting

confidence: 63%

“…This finding was higher than the rate observed from Nigeria (23%) [24], it was similar to those seen in Cameroon (62%) [13] and Kenya (57%) [26], but lower than the findings from Ethiopia where 91% of the patients defaulted during the continuation phase [12]. One possible explanation for the early default could be feeling better shortly after initiation of treatment.…”

Section: Discussionsupporting

confidence: 53%

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Determinants of Tuberculosis treatment default in Morocco: results from a national cohort study

Tachfouti¹,

Slama²,

Berraho³

et al. 2013

Pan Afr Med J

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IntroductionStudies have shown an association between smoking and tuberculosis (TB) infection, disease and TB-related mortality. We thus documented the impact of smoking and others factors on TB treatment default.MethodsA cohort of 1039 new TB cases matched on smoking status was followed between 2004 and 2009 in eight Moroccan regions. Treatment default was defined according to international criteria. Univariate analyses were used to assess associations of treatment default with smoking status and demographic characteristics. Multivariate logistic regression was used to adjust for potential confounding.ResultsPatients’ mean age was 35.0 ±13.2 years. The rate of treatment default was 30.2%. Default was significantly higher among men, smokers, persons living in urban areas and non-religious Muslims. After adjusting for confounding variables, factors that remained significantly associated with treatment default were: being male (OR = 3.2; 95% CI: 1.2-8.7), being a non-religious Muslim (OR = 2.0; 95% CI: 1.4-2.9) and living in an urban area OR = 3.0; 95% CI: 1.8-4.9).ConclusionThe high rate found for default suggests important program's inadequacies and an urgent need for change. Therefore continued research of predictors of default and strategies to reinforce adherence is recommended.

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“…TB patients in Africa often default in the hospitalization phase: hospitalization is problematic due to poor general conditions in TB hospitals, costs incurred by patients during hospitalisation and because patients need to earn living or take care of their families 11. Stock ruptures, shortage of reagents and drugs and low salaries produce lack of motivation and poor morale impairing health personnel’s work and dramatically reducing diagnostic and treatment performances in Africa.…”

Section: Discussionmentioning

confidence: 99%

Short Term Advantages of a Public-Private Partnership for Tuberculosis in Guinea Bissau: Reduction of Mortality and Increased Diagnostic Capacity

Vieira

Sanha²,

Riccardi

et al. 2014

Mediterr J Hematol Infect Dis

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BackgroundTuberculosis (TB) is widespread in Africa, but weak health systems in developing countries, often display poor quality of care with delays in case identification, irrational therapy and drug shortage, clinical mismanagement, unnecessary expenditures for patients, reduced adherence and increased mortality. Public-private partnership has demonstrated to increase TB case detection, but less is known about its effects on quality of care, mortality and costs for hospitalized TB patients.MethodsClinical outcomes and costs for TB patients at the TB National Reference Center of Bissau, in Guinea Bissau, West Africa, were determined during the first 5 months of the public-private management and compared to the ones of previous years when the hospitals was under direct Government’s management.Results215 (2009–2010) and 194 (2012–2013) patients were admitted, respectively. Improvement (p<0.05) was observed in mortality reduction (21% vs 6%), cause of death determination (50% vs 85%), treatment abandonment (15 vs 1). Direct costs for patients during TB diagnostic pathway and inpatient care were significantly reduced, 475 vs. 0 USD.ConclusionsPublic-private partnerships displays significant short term benefits in National TB reference centers, even in post-conflict countries. Further studies could aid in determining the overall long term benefits of this type of cooperation, and the specific characteristic of TB and concomitant hematologic and infectious diseases in TB admitted patients.

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Tuberculosis treatment default in a large tertiary care hospital in urban Nigeria: Prevalence, trend, timing and predictors

Abstract: TB treatment default is high and must be reduced. This may be achieved through improved rural DOT, further patient education, and enhanced coordination of TB/HIV care.

Cited by 33 publications

References 10 publications

Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case-control study

Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case-control study

Determinants of Tuberculosis treatment default in Morocco: results from a national cohort study

Short Term Advantages of a Public-Private Partnership for Tuberculosis in Guinea Bissau: Reduction of Mortality and Increased Diagnostic Capacity

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