Treatment Completion Rates of Tuberculosis Infection at the Chest Clinic, Korle-Bu Teaching Hospital, Ghana from 2018-2020

Abstract

Background: Tuberculosis (TB) remains a major public health challenge in countries of sub- Saharan Africa, and it is one of the top 10 causes of death worldwide. The burden of TB is further compounded by interruption in treatment. An estimated 13,978 cases of TB have been reported in Ghana annually. Yet only 32% were detected and notified, with 21% cases co-infected. Low completion treatment rates indicate high rates of adverse treatment outcomes. If this situation is left unresolved, there will be increased multidrug-resistant, increased morbidity and mortality rates and prolonged treatment periods. Aims: The study sought to determine the burden of TB co-infection and treatment completion rate. Methods: A retrospective records review was conducted at the Korle-Bu Teaching Hospital using TB registers between January 2018 and December 2020. Data extraction guide was developed in Microsoft excel and pre-tested. Simple descriptive statistics such as means, proportions and standard deviation were used to summarized both categorical and continues variables. A chi-square test was conducted to determine association between treatment factors and socio-demographic characteristics, co-infection (HIV) and treatment completion rates. Logistic regression analysis was used to determine the strength of associations between treatment factors, co-infection and independent variables (such as socio-demographic characteristics). Results: In general, more males (56%) than females (44%) seek treatment for TB at the Korle-Bu Teaching Hospital. Out of the 350 TB patients, prevalence of TB/HIV co-infection was 34.3%-profound in males (55.8%), those residing in urban settings (87.5%) and in year 2020 (50%). Overall treatment completion rate was 71.7% - significantly higher among males (51.8%), participants residing in urban settings (81.3%) and those who tested negative for HIV (67.3%). Yet, treatment completion rate had reduced in 2020 (72.2%) compared to 2019 (79.2%). Independent predictors of treatment completion were found to be: being male [AOR=0.34 (95% CI: 0.19-0.62); p<0.001] and complains of drug side effects [AOR=0.13 (95% CI: 0.07-0.24); p<0.001]. Conclusion: Majority of TB patients for the years under review were males and resides in urban communities. About one-third were diagnosed of extra-pulmonary. Prevalence of TB-HIV co-infection was quite high, more prevalent in urban districts, and remained steady for two years and significantly increased in 2020.