Factors Associated With Tuberculosis Treatment Success in Kwahu West Municipality

Abstract

Background: Tuberculosis threatens public health all over the world and affects persons mostly in their productive lives (WHO, 2015a). Treatment success is a key indicator for assessing effectiveness of TB control programme. Effective treatment success is a major element for reducing transmission and reducing incidence of Multidrug resistance TB (NTCP, 2013). Global treatment success has experienced a tremendous improvement since the establishment of annual collection of data on TB in 1995. Treatment success improved from 57% in 1995 to 84% in 2005 and maintained at 86% since 2012. Ghana shares the mission of the Global Stop TB partnerships which aims at achieving at least 90% treatment success rate by 2020 and beyond (UNOPS, 2016). In 2014, the Ghana national treatment success rate was 85% (WHO, 2015a). Ghana has experienced progressive improvement in treatment success from 43.6% in 1998 to 85% in 2014 (NTCP, 2013; WHO, 2015a), however, the treatment successes are not the same across the regions, Districts or facilities. Eastern regional 2016 annual report shows that the region achieved 84% in 2013, 86% in 2014 and 83% in 2015 and only nine districts out of 26 districts in the region achieved the regional target of 90% of treatment success in 2014 and Kwahu west Municipality achieved 67.7% treatment success in 2014, the lowest in the region. Methods: A five-year retrospective document review was employed to determine the treatment outcomes and associated factors among TB patients registered and treated from 1st January 2012 to 31st December, 2016 in Kwahu West Municipality in the Eastern Region of Ghana. A chi-square test was used to determine factors associated treatment outcome and multiple logistic regression was used to determine the magnitude of association with the treatment outcome Results: The overall Treatment success for the five-years period is 83.3% which ranges from 77% to 87%. There is no significant association between sex and treatment success (M=82.3%, F=85.9%, χ2 =0.47, P=0.493), there is no significant association between residence and treatment success (U=84.5%, R=81.0%, χ2 =0.51, P=0.476), there is an association between patients’ weight and treatment success (χ2 =14.5, p= 0.001), and also BMI Category and treatment success (χ2 =10.13, p = 0.006) and there is a significant difference in the weight of patients before treatment (M=50.9Kg, SD=7.8Kg) and weight of patients after being on treatment for four months (M=55.1Kg, SD=8.3Kg; t=16.5, p < 0.001). Conclusion: Age, patients’ weight and BMI were found to be associated with treatment success. Treatment success increased with increasing patients’ weight, but treatment success decreased with increasing age. Sex, place of residence, patient type, HIV and Disease classification were not associated with treatment success. Keywords: TB treatment success, Outcomes of TB treatment, Global TB burden, Tuberculosis in Ghana, BMI and TB outcomes, weight and TB.