Determinants of Treatment Outcome of Public-Private Mix Tuberculosis Control Programme in South-Eastern Nigeria

Abstract

Background: Determinants for non-compliance to antituberculosis treatment range from a poor correlation between patient and programme needs and priorities among other socio-economic factors.
Objectives: This is to assess determinants of treatment outcome of public private mix tuberculosis control programme in South-Eastern Nigeria.
Methods: A retrospective cohort study design using Multivariate Logistic Regression to analyze secondary data set (2007-2010) of patients to assess determinants of TBDirectly Observed Treatment Short course Treatment outcomes in public and private facilities in Anambra State.
Results: A total of 2,018 patients (1,899 patients in public health facilities and 119 in private health facilities) were reviewed. The mean ages in public and private facilities were 34.0±4.2 years and 32±3.7 years. Males were 60.0% (1100 patients) and 75%(90 patients) at public and private health facilities respectively. Cure rates of 37.6%(714 patients) and 48.7%(61patients);Defaulter rates of 28.2%(532 patients) and 7.6%(9 patients); Interruption rates of 3.9%(74 patients) and 0%(0 patients); Transfer-out rates of 3.2%(61 patients) and 1.7% (2 patients);Failure rates of 1.9%(36 patients) and 0.8%(1 patient);Death rates of 4.1%(78 patients) and 0.8%(1 patient); and treatment completion rates of 19.7%(375 patients) and 6.7%(8 patients) were found at public and private health facilities respectively.
Conclusion: Determinants that affected treatment outcome for public facilities were year, HIV status of patients, category of treatment, sex and age of patients. The determinant for private facilities was only year. Future research should focus on identifying factors that influence health seeking behaviour to accessing care in private facilities.

Key words: Tuberculosis, Determinants, Treatments Outcome, Public-Private Mix.