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Front. Med. | doi: 10.3389/fmed.2018.00038

Treatment outcomes of tuberculosis at Asella Teaching Hospital: Ten years’ retrospective aggregated data

  • 1Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong
  • 2Department of Public Health, Arsi University, Ethiopia
  • 3Leishmaniasis Research Laboratory, Ethiopian Public Health Institute, Ethiopia
  • 4Department of Pharmacy, Arsi University, Ethiopia
  • 5Department of Medical, German Leprosy and TB Relief Association (GLRA), Ethiopia

Background: Directly Observed Treatment Short-course (DOTS) has been one of the major strategies to combat the epidemic of tuberculosis (TB) globally. This study aimed to evaluate TB treatment outcomes between September 2004 and July 2014 under the DOTS program at one of the largest public hospitals in Ethiopia.
Methods: A retrospective data of TB patients registered at Asella Teaching Hospital between September 2004 and July 2014 were obtained from hospital registry. Treatment outcomes and types of TB cases were categorized according to the national TB control program guideline. Binomial and multinomial logistic regression models were used to analyze the association between treatment outcomes and potential predictor variables.
Results: A total of 1,755 TB patients’ records were included in the study. Of these, 945 (53.8%) were male, 480 (27.4%) smear positive TB, 287 (16.4%) HIV positive, and 1,549 (88.3%) new cases. Among 480 smear positive pulmonary TB cases, 377 (78.5%) patients were cured, 21 (4.40) completed the treatment, 35 (7.3%) transferred out, 19 (4.0%) died, 24 (5.0%) defaulted, and 4 (0.8%) failure. Overall, 398 (82.9%) smear positive pulmonary TB patients were successfully treated. For smear negative TB (n=641) and extra-pulmonary TB cases (n=634), 1036 (81.3%) completed the treatment and demonstrated favorable response. Taking all TB types into account, 1434 (81.7%) were considered as successfully treated. In the multivariate binary logistic model, patients in older age group (AOR = 0.386, 95% CI: 0.250-0.596) and retreatment cases (AOR = 0.422, 95% CI: 0.226-0.790) were less likely to be successfully treated compared to younger and new cases, respectively. In multinomial logistic regression, age increment by 1 year increased the risk of death and default of TB patients by 0.05 (adjusted β=0.05; 95% CI: 0.03, 0.06) and 0.02 (adjusted β= 0.02; 95% CI: 0.01, 0.04). The odds of TB patients who died during treatment were higher among HIV-infected TB patients (adjusted β = 2.65; 95% CI: 1.28, 5.50).
Conclusions: The treatment success rate of TB patients was low as compared to the national target. TB control needs to be strengthened for the enhancement of treatment outcome.
Keywords: Tuberculosis, Asella, outcomes, Smear positive pulmonary tuberculosis, Smear-negative

Keywords: Tuberculosis, Asella, outcomes, Smear positive pulmonary tuberculosis, Smear negative pulmonary tuberculosis

Received: 26 Sep 2017; Accepted: 31 Jan 2018.

Edited by:

Sunil Dhiman, Defence Research and Development Establishment (DRDO), India

Reviewed by:

Sarman Singh, All India Institute of Medical Sciences, India
Pallab Ghosh, Harvard Medical School, United States
JOSE R. LAPA E SILVA, Universidade Federal do Rio de Janeiro, Brazil
Nicole Fogel, University of Toronto, Canada  

Copyright: © 2018 Tulu, Beyen, Hirpa, Tassew, Mekit, Sisay, Tadesse and Siu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mr. Ketema Tafess T. Tulu, Hong Kong Polytechnic University, Health Technology and Informatics, Kowloon, Y607, Hong Kong,
Dr. Kit Hang Gilman Siu, Hong Kong Polytechnic University, Health Technology and Informatics, Kowloon, Y607, Hong Kong,