Akinola A Fatiregun1, Abimbola S Ojo, Afolabi E Bamgboye. 1. Department of Epidemiology, Medical Statistics and Environmental Health, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. akinfati@yahoo.com
Abstract
OBJECTIVE: To assess treatment outcomes and determinants of outcome among tuberculosis patients. DESIGN: A longitudinal study design involving a cohort of sputum smear-positive pulmonary tuberculosis patients at initiation of therapy, who were followed up to the end of treatment at eighth month. SETTING: Tuberculosis treatment centers in Ibadan, Nigeria. RESULTS: A total of 1,254 patients were followed up with a mean age of 35.0+/-3.3 years. The percentages of patients with treatment outcomes assessed in the study were as follows: cure (76.6%), failure (8.1%), default (6.6%), transferred out (4.8%), and death (1.9%). The cure rate varied significantly between treatment centers from 40 to 94.4% (P<0.05). The treatment centers located within the specialist health centers at Jericho and the University College Hospital had 50 and 75% cure rates, respectively.The mean age of cured patients was 31.2+/3.1 years which was significantly lower than the mean age of those with poor treatment outcomes (36.7+/3.5 years; P<0.05). Males had a higher risk of a poor treatment outcome (RR=1.8; 95% CI: 1.02-1.94) than females. Also, patients with a poor knowledge of tuberculosis had a higher risk of having a poor treatment outcome (RR=1.35; 95% CI: 1.25-1.62) compared to those with knowledge. CONCLUSION: Variations in health center treatment outcomes and poor knowledge of tuberculosis among patients suggest that poor program implementation quality may be a major modifiable determinant of treatment outcomes in our environment.
OBJECTIVE: To assess treatment outcomes and determinants of outcome among tuberculosispatients. DESIGN: A longitudinal study design involving a cohort of sputum smear-positive pulmonary tuberculosispatients at initiation of therapy, who were followed up to the end of treatment at eighth month. SETTING:Tuberculosis treatment centers in Ibadan, Nigeria. RESULTS: A total of 1,254 patients were followed up with a mean age of 35.0+/-3.3 years. The percentages of patients with treatment outcomes assessed in the study were as follows: cure (76.6%), failure (8.1%), default (6.6%), transferred out (4.8%), and death (1.9%). The cure rate varied significantly between treatment centers from 40 to 94.4% (P<0.05). The treatment centers located within the specialist health centers at Jericho and the University College Hospital had 50 and 75% cure rates, respectively.The mean age of cured patients was 31.2+/3.1 years which was significantly lower than the mean age of those with poor treatment outcomes (36.7+/3.5 years; P<0.05). Males had a higher risk of a poor treatment outcome (RR=1.8; 95% CI: 1.02-1.94) than females. Also, patients with a poor knowledge of tuberculosis had a higher risk of having a poor treatment outcome (RR=1.35; 95% CI: 1.25-1.62) compared to those with knowledge. CONCLUSION: Variations in health center treatment outcomes and poor knowledge of tuberculosis among patients suggest that poor program implementation quality may be a major modifiable determinant of treatment outcomes in our environment.
Authors: Magda Maruza; Maria F P Militão Albuquerque; Isabella Coimbra; Líbia V Moura; Ulisses R Montarroyos; Demócrito B Miranda Filho; Heloísa R Lacerda; Laura C Rodrigues; Ricardo A A Ximenes Journal: BMC Infect Dis Date: 2011-12-16 Impact factor: 3.090
Authors: Bárbara Reis-Santos; Teresa Gomes; Laylla R Macedo; Bernardo L Horta; Lee W Riley; Ethel L Maciel Journal: Int J Equity Health Date: 2013-08-20
Authors: Bárbara Reis-Santos; Teresa Gomes; Rodrigo Locatelli; Elizabete R de Oliveira; Mauro N Sanchez; Bernardo L Horta; Lee W Riley; Ethel L Maciel Journal: PLoS One Date: 2014-07-08 Impact factor: 3.240