Childhood Tuberculosis in a Sub-Saharan Tertiary Facility: Epidemiology and Factors Associated with Treatment Outcome (original) (raw)
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PLOS ONE
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Background In Gondar University Teaching Hospital standardized tuberculosis prevention and control programme, incorporating Directly Observed Treatment, Short Course (DOTS) started in 2000. According to the proposal of World Health Organization (WHO), treatment outcome is an important indicator of tuberculosis control programs. This study investigated the outcome of tuberculosis treatment at Gondar University Teaching Hospital in Northwest Ethiopia. Methods We analyzed the records of 4000 tuberculosis patients registered at Gondar University Teaching Hospital from September 2003 to May 2008. Treatment outcome and tuberculosis type were categorized according to the national tuberculosis control program guideline. Multivariate analysis using logistic regression model was used to analyse the association between treatment outcome and potential predictor variables. Results From the total of 4000 patients, tuberculosis type was categorized as extrapulmonary in 1133 (28.3%), smear negative pulmonary tuberculosis in 2196 (54.9%) and smear positive pulmonary tuberculosis in 671 (16.8%) cases. Of all patients, treatment outcome was classified as successfully treated in 1181(29.5%), defaulted in 730 (18.3%), died in 403 (10.1%), treatment failed in six (0.2%) and transferred out in 1680 (42.0%) patients. Males had the trend to be more likely to experience death or default than females, and the elderly were more likely to die than younger. The proportion of default rate was increased across the years from 97(9.2%) to 228(42.9%). Being female, age group 15-24 years, smear positive pulmonary tuberculosis and being urban resident were associated with higher treatment success rate. Conclusion The treatment success rate of tuberculosis patients was unsatisfactorily low (29.5%). A high proportion of patients died (10.1%) or defaulted (18.3%), which is a serious public health concern that needs to be addressed urgently.
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Mycobacterial Diseases, 2013
Background: Tuberculosis (TB) is a serious public health problem in the developing countries. Early diagnosis, effective treatment and continues assessment of treatment outcome are important indicators of TB control. Objective: To assess the trend of TB and treatment outcomes, in the past five years in Gambella region with special emphasize on Gambella hospital, South Western Ethiopia. Methods: In this retrospective study, a five year (2006 to 2010) TB cases record review was done to assess the trend and treatment outcomes of TB patients in Gambella Region. Bivariable and multivariable logistic regression analyses were performed to assess the association between treatment outcomes and predictor variables. Results: From the total of 5071 TB patients registered during the indicated period, 4813 (94.91%) were new cases and 258 (5.09%) were retreated cases. Trend in annual incidence rate of all forms of TB decreased from 581 per 100,000 population in 2006 to 247 per 100,000 population in 2007, and then, increased in the year 2010 (263 per 100,000 population). From 2303 patients registered at regional hospital, 529 (23.00%), 1158 (50.35%) and 671 (26.65%) were extra pulmonary tuberculosis (EPTB), smear negative pulmonary tuberculosis (SNPTB) and smear positive pulmonary tuberculosis (SPPTB) cases, respectively. Regarding treatment outcomes, 1460 (63.40%) were successfully treated, 527 (22.88%) defaulted, 83 (3.60%) died, 2 (0.09%) failed and 231 (10.00%) patients were transferred out. Age of patients' above 15 years was significantly associated with low treatment success rate (TSR) (AOR=0.553, 95% CI, 0.423, 0.723, p<0.001). Whereas, being female TB patients was significantly associated with high TSR (AOR=1.226, 95% CI, 1.031, 1.457, p=0.002). Conclusion: Incidence rate of TB in the region showed a fluctuating pattern for the last five years with an estimated mean annual incidence rate of 322 per 100,000 population. Furthermore, the proportion of SNPTB cases was remained highest compared to cases of SPPTB and EPTB. The TSR of all types of TB in the region was unsatisfactory. Hence, strengthening health extension programs, continuous follow-up, supervision of treatment adherence and defaulters tracing should be strengthened to improve TSR and reduce TB burden in the region