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Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study in Jos North and Mangu, Plateau State, North – Central Nigeria
Comfort Nanbam Sariem
University of Jos
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4915-7936
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State, North-Central Nigeria.
Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.
Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ±SD was 35.5 ±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p=0.028) more likely to be associated with treatment success than having an unknown status. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.
Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.
Keywords
Tuberculosis, Treatment Outcomes, Retrospective Study, Plateau State, Nigeria
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CURRENT STATUS: Published
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Posted 26 May, 2020
Published
On 11 Aug, 2020
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On 28 May, 2020
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Received 17 May, 2020
Review #1 received
Received 15 May, 2020
Reviewers invited
Invitations sent on 14 May, 2020
Reviewer #1 agreed
On 14 May, 2020
Reviewer #2 agreed
On 14 May, 2020
Editor assigned
On 14 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
No comments provided
Editorial decision: Major revision
On 15 Apr, 2020
Editor assigned
On 14 Apr, 2020
Submission checks complete
On 13 Apr, 2020
Editor invited
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Editorial decision: Major revision
On 09 Mar, 2020
Review #1 received
Received 13 Nov, 2019
Reviewers invited
Invitations sent on 12 Nov, 2019
Reviewer #1 agreed
On 12 Nov, 2019
Editor assigned
On 21 Oct, 2019
Submission checks complete
On 20 Oct, 2019
Editor invited
On 20 Oct, 2019
No comments provided
Editorial decision: Major revision
On 25 Aug, 2019
Review #1 received
Received 21 Aug, 2019
Review #2 received
Received 21 Aug, 2019
Reviewer #1 agreed
On 19 Aug, 2019
Reviewer #2 agreed
On 19 Aug, 2019
Reviewers invited
Invitations sent on 23 Jul, 2019
Submission checks complete
On 08 Jul, 2019
Editor assigned
On 05 Jul, 2019
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On 04 Jul, 2019
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study in Jos North and Mangu, Plateau State, North – Central Nigeria
Comfort Nanbam Sariem
University of Jos
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4915-7936
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 26 May, 2020
Published
On 11 Aug, 2020
No community comments so far
Editorial decision: Major revision
On 28 May, 2020
Review #2 received
Received 17 May, 2020
Review #1 received
Received 15 May, 2020
Reviewers invited
Invitations sent on 14 May, 2020
Reviewer #1 agreed
On 14 May, 2020
Reviewer #2 agreed
On 14 May, 2020
Editor assigned
On 14 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
No comments provided
Editorial decision: Major revision
On 15 Apr, 2020
Editor assigned
On 14 Apr, 2020
Submission checks complete
On 13 Apr, 2020
Editor invited
On 13 Apr, 2020
No comments provided
Editorial decision: Major revision
On 09 Mar, 2020
Review #1 received
Received 13 Nov, 2019
Reviewers invited
Invitations sent on 12 Nov, 2019
Reviewer #1 agreed
On 12 Nov, 2019
Editor assigned
On 21 Oct, 2019
Submission checks complete
On 20 Oct, 2019
Editor invited
On 20 Oct, 2019
No comments provided
Editorial decision: Major revision
On 25 Aug, 2019
Review #1 received
Received 21 Aug, 2019
Review #2 received
Received 21 Aug, 2019
Reviewer #1 agreed
On 19 Aug, 2019
Reviewer #2 agreed
On 19 Aug, 2019
Reviewers invited
Invitations sent on 23 Jul, 2019
Submission checks complete
On 08 Jul, 2019
Editor assigned
On 05 Jul, 2019
First submitted
On 04 Jul, 2019
Editor invited
On 04 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State, North-Central Nigeria.
Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.
Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ±SD was 35.5 ±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p=0.028) more likely to be associated with treatment success than having an unknown status. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.
Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.
Figure 1
Figure 2