Appraising Treatment Outcomes of Cohort of Smear-positive Patients with Tuberculosis (TB) alone and TB-HIV Co-infected on Directly Observed Treatment Short Course (DOTS) at a Teaching Hospital in Enugu State, Nigeria
E. C. Aniwada *
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria.
O. D. Onodugo
Department of Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria.
C. N. Onwasigwe
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria.
O. I. Ajayi
Department of Epidemiology, Medical Statistics, Faculty of Public Health, University of Ibadan, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Tuberculosis and Human Immunodeficiency Virus are overlapping monsters presenting an enormous economic burden, suffering, pain and grief globally. They have high mortality rates and most international efforts to control infectious diseases focus on these diseases yet they still pose a great threat.
Methods: This study was conducted at the Chest Clinic of University of Nigeria Teaching Hospital (UNTH) Enugu. It involved a retrospective appraisal of treatment outcomes of cohort of smear-positive patients with Tuberculosis (TB) alone and TB-HIV co-infected on Directly Observed Treatment Short-course (DOTS) who were initiated on TB treatment and completed treatment in the period 2008 to 2011. A proforma was used in collecting data. Chi-square test and Binary Logistic regression to establish associations and identify predictors of treatment outcomes
Results: Most patients 322(73.7%) were declared cured at end of treatment [TB alone 281(75.7%) and TB/HIV coinfection 41(65.1%)]. Treatment outcome were associated with disease status (p =0.022) and distance to the clinic (p =0.017). Those that had TB alone were about 0.6 times (AOR 0.56; 95% CI 0.33-1.63) likely not to be cured than those with TB/HIV. Those that travel 0-20 km to the clinic were about 0.5 times (AOR 0.50; 95% CI 0.28-0.91) likely not to be cured than those that travel more than 80 km.
Conclusion: Even with the moderately high cure rate among these patients, effort are needed by stakeholders and all populace in curbing this ravaging menace. Equally the identified predictors of treatment outcome were TB/HIV co-infection and distance from residence to the clinic which should be addressed.
Keywords: Tuberculosis, HIV, co-infection, treatment outcome