Treatment Outcome and Associated Factors among TB Patients in Ethiopia: Hospital-Based Retrospective Study

Abstract

Background: Tuberculosis remains a major global health problem and ranks alongside the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. For effective tuberculosis control, it is a pre-requisite to detect the cases as early as possible, and to ensure that the tuberculosis patients complete their treatment and get cured. However, in many resource-constrained settings treatment outcome for tuberculosis has not been satisfactory. Objective: The aim of the study was to assess the treatment outcome of tuberculosis and investigate the association of demographic and clinical factors with treatment success of patients enrolled in selected hospitals, Ethiopia. Methods: A fifteen-year retrospective register based historical data were collected through medical record review from 31 selected hospitals in Ethiopia. Data were analyzed using SPSS version 20 and to investigate the association of demographic and clinical factors with treatment success of patients, multiple logistic regression methods were used. A ? value of less than 5% was considered as statistically significant in the final model. Result: Out of the 90,191 registered tuberculosis patients (50,167 males and 40,024 females) including all age group, 55.8% had successful treatment outcome and 44.2% had unsuccessful outcome. In the multivariate logistic model, the odds of unsuccessful treatment outcome was relatively higher among patients in the age group of >65 (AOR = 1.283, 95% CI: 1.186-1.387), unknown presumptive MDR TB (AOR=1.17, 95% CI:1.07-1.279) and unknown smear result (AOR=1.706, 95% CI:1.611-1.807); and was lower in age group 15-24 (AOR = 0.818, 95% CI: 0.781-0.857), among female patients (AOR = 0.89, 95% CI: 0..866-0.914) and extra pulmonary TB patients (AOR=0.889, 95% CI:0.848-0.932 as compared to their respective comparison groups. Conclusion: In this study, high proportion of unsuccessful treatment outcome was documented, therefore emphasis has to be given for patients with high risk of unsuccessful TB treatment outcome and targeted interventions should be carried out. All patients’ background characteristics were significantly associated with the treatment success status. And a continuous follow-up of patients with frequent supportive supervision during the course of treatment is recommended.