Eight Months vs Six Months Anti-TB Regimen in the Treatment of Newly Diagnosed Pulmonary Tuberculosis Patients in Nigeria
Olusoji James Daniel *
Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria.
Olusola Adedeji Adejumo
Department of Community Health and Primary Health Care, Lagos State University Teaching Hospital, Ikeja Lagos, Nigeria
Hussein Abdulrrazzaq
Lagos State TB and Leprosy Control Programme, Lagos State Ministry of Health, Lagos State, Nigeria.
Mustapha Gidado
Department of Project and Operations, TB CARE 1 Project Abuja, FCT, Nigeria
Olajumoke Onazi
Department of Research Monitoring and Evaluation, TB Care 1 Project Abuja, FCT, Nigeria.
Gabriel Akang
National TB and Leprosy Control Programme, Federal Ministry of Health Abuja, FCT, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: The eight month’s treatment regimen (2RHZE/6EH) was used by the Nigerian National TB and Leprosy Control Programme for the management of tuberculosis cases since 2003 when they commenced operation until October 2010 when the six month’s treatment regimen (2RHZE/4RH) was introduced. This study compared the treatment outcomes of patients managed with eight and six month’s treatment regimen between October 2009 and December 2011.
Methods: A desk review was carried out on the programme data of the Lagos State Tuberculosis and Leprosy Control Programme (LSTBLCP). The treatment outcomes of new smear positive TB patients managed between October 2009 and September 2010 (the eight month’s treatment regimen period) and January to December 2011 (six month’s treatment regimen period) were compared using Epi Info 2007 statistical software.
Results: A total of 4249 and 4167 smear positive TB patients were registered during the eight and six month’s treatment regimen period respectively. The prevalence of HIV among TB patients was significantly higher (14.4%) during the eight month’s treatment regime period compared with the six month’s (12.1%) treatment regime period (P = .02). The cure rate of patients managed during the eight month’s treatment regimen period was significantly lower (67.2%) and defaulter rate significantly higher (16.7%) compared with the cure (73.9%) and defaulter rates (12.2%) of patients managed during the six month’s treatment regimen period (P<.001). However the failure and death rates of patients managed during the eight and six month’s treatment regimen periods were comparable (P>.05). Among TB/HIV co-infected patients, the death rate was significantly higher among patients managed during the six month’s regimen period and the default rate was significantly higher in patients managed during the eight month’s treatment regimen period (p<.05).
Conclusion: Patients had better treatment outcomes during the six month’s treatment regimen period in Lagos State. Sustaining these gains will be essential in reaching the national and global targets.
Keywords: Tuberculosis, effectiveness, treatment, anti-TB regimen, Nigeria