Treatment Outcomes and Associated Factors of Tuberculosis Patients on Directly Observed Treatment (Short Course) in a Tertiary Hospital in Port Harcourt, Nigeria

Abstract

Introduction: Although concerted efforts have been implemented to achieve tuberculosis (TB) prevention and control, varying  outcomes have been reported in several quarters, despite the implementation of the directly observed treatment short-course (DOTS) strategy in virtually all parts of the world. It was considered necessary to assess the treatment outcomes of TB patients on DOTS strategy and the associated factors against the World Health Organization (WHO) target at the University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt, to stimulate improvements in efforts toward patients care in the hospital and elsewhere.

Methods: Ahealth facility‑based review of patients’ records(January 1, 2014–December 31, 2018) at the TB Clinic of UPTH was carried out using a validated data record sheet. Patients undergoing treatment were excluded. Data were analyzed with the SPSS software version 20. Outcome frequencies were summarized, and the Pearson’s Chi‑square test was used to determine the association between the outcome and independent variables at P ≤ 0.05 statistical significance level.

Results: Overall, 174 (25.7%) had completed treatment, 181 (26.7%) were cured, 95 (14.0%) died, 70 (10.3%) transferred out, 45 (6.6%) defaulted, 49 (7.2%) were not evaluated, 44 (6.5%) were lost to follow‑up, and 8 (1.2%) failed treatment. There was a 17.6% decline in the proportion of patients that completed treatment from 35.9% in 2014 to 18.3% in 2018. On the contrary, there was an increase in the proportion of patients that were cured, from 14.1% in 2014% to 26.1% in 2018.

Conclusions: The treatment success rate for TB in the hospital was below the WHO benchmark of 85% cure rate throughout the period under review. Basic reforms in the service delivery processes that specifically targets groups at risk (male patients, sputum  smear‑negative TB patients, and patients with human immunodeficiency virus/TB co-infection) with drug adherence counselling, defaulter tracing arrangements, and emphasis on drug‑susceptibility testing are recommended to improve treatment outcomes.

Keywords: Directly observed treatment short-course, Nigeria, Rivers State, tuberculosis treatment, tuberculosis outcomes