Tuberculosis Treatment Outcome and Associated Factors at the Tetteh Quarshie Memorial Hospital

Abstract

Tuberculosis threatens public health all over the world and affects persons mostly in their productive lives. The proportion of cases with successful treatment outcome is a key indicator to assess the effectiveness and performance of any Tuberculosis Control Programme. Effective treatment is a major element in reducing the transmission of infection and ultimately achieving elimination of the disease. The study was conducted to determine factors associated with treatment outcome and the proportion of TB patients cured, completed treatment and defaulted treatment during the period January 2009 to December 2013. A descriptive, cross sectional study was carried out. It involved a retrospective review of TB treatment cards of patients who received tuberculosis treatment in the counselling unit of the hospital from 2009-2013. Data on age, sex, distance from place of residence to DOTS center, HIV voluntary counselling and testing, HIV status, type of patient, treatment supporter, other co-morbidities, diagnostic category, duration of treatment and adverse drug reactions were extracted. Factors associated with treatment success as well as adverse outcome during treatment were assessed by chi square test, bivariate and multivariate logistic regression models. Of the 415 patients studied, 146 (35.2%) were cured, 167 (40.2%) completed treatment and 86 (20.7%) defaulted treatment. Treatment success was 75.4% (313/415).Patients with HIV/TB co-infection were 114 (27.5%).The treatment success of 75.4% was lower than the Ghanaaverage for 2011 of 86.5% and WHO target of 85%. In the multivariate analysis, factors associated with treatment success were the presence of a treatment supporter (AOR 9.69, CI 4.89-19.21). Adverse treatment outcome was associated with patients aged more than 60 years (AOR 0.27, CI 0.08-0.89), smear negative TB (AOR 0.26, CI 0.15-0.47), transferred-in patients (AOR 0.23, CI 0.02-0.75) as well as patients who experienced adverse drug reactions (AOR 0.12, CI 0.03-0.44). Enhanced supervision to improve treatment success, improved health education with special emphasis on the need for adherence to treatment, effect of drugs and the importance of treatment supporters are encouraged. Contact tracing should be strengthened to assist patients during treatment.