Magnitude and associated factors with unfavorble treatment Outcomes of tuberculosis patients under directly observed Treatmrnt short course in debreberhan referral hospital, north Shoa zone, ethiopia

Abstract

Background: Tuberculosis is the leading cause of mortality among infectious disease worldwide. Despite many efforts to put TB under control, even now the disease remains to be a major public health problem. For effective prevention and control of tuberculosis it is a pre requisite to detect the cases as early as possible and to ensure that the tuberculosis patients are completes their treatment and get cured. Assessing treatment outcome and associated factors with unfavorable treatment outcomes of tuberculosis patients enrolled in DOTs helps to find the gaps of the service delivered in DOTs program and improve services for better favorable treatment outcome, to reduce recurrence of tuberculosis, development of multi-drug resistance and extensive drug resistance form of tuberculosis Objective: To determine magnitude and associated factors with Treatment outcome of Tuberculosis patients under DOTs in Debre Berhan Referral Hospital, North Shoa Zone, Ethiopia Methods: A cross sectional study covering the period of January 2009 to December 2013 was employed. After the completion of data collection; editing, coding and cleaning was carried out. Data were entered using EPi-info version 3.2.2 and was exported into SPSS version 16.0 statistical software and analysis was performed. Bivariate logistic regression analysis was used to see significance of association between unfavorable treatment outcome and independent variables. All explanatory variables that were associated with the outcome variable and those with p-value < 0.25 in binary logistic regression analysis were included in multiple logistic regression analysis. P-value <0.05 was considered as a statistical significant. Result: Records of 1280 registered tuberculosis patients (n=649 males and 631 =females) were included in this study. Of these patients 15.95% were documented as being cured, 63.5 % as treatment completed, 1.8% dead during follow up, 0.3% treatment failure, 8.0% were reported as defaulter, and 10.5% were transferred out to another health facility. Patient’s residence, types of TB and follow –up sputum smear microscopic examination at 2nd months of treatment were significantly associated with unfavorable treatment outcomes. Conclusion and recommendation: The unfavorable treatment outcomes of tuberculosis patients were high (20.6%). A high proportion of TB patients were defaulted (8.0%) and transfer out (10.5%) which is a serious public health problem that needs to be addressed urgently. Being rural dwellers were 1.4 times more likely to experience unfavorable treatment outcome than urban dwellers, being pulmonary TB negative and extra-pulmonary type were 70.5% and 72% less risky for unfavorable Treatment outcomes, respectively than Pulmonary TB positive type and having negative sputum smear result at second month of treatment had a 90% reduction in experiencing unfavorable treatment outcome when compared to sputum smear result positive during that follow up period. Continuous strong supportive supervision, defaulter tracing, health education about TB and its treatment and the necessities of follow up sputum examinations are strongly recommended