Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia

Tuberculosis (TB) is one of the major public health and socio-economic issues in the 21^stcentury globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS) are among the major indicators of the performance of a national TB control program. 

Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013) TB record of TB clinic of the hospital was reviewed. 

A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3%) were male, 1015 (66%) were from rural areas, 544 (35.4%) were smear positive pulmonary TB (PTB+), 816 (53.1%) were smear negative pulmonary TB (PTB-) and 177(11.5%) were extra pulmonary TB (EPTB) patients. Records of the 1537 TB patients showed that 181 (11.8%) were cured, 1129(73.5%) completed treatment, 171 (11.1%) defaulted, 52 (3.4%) died and 4 (0.3%) had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012–May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21–2.20) compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26–2.50) and EPTB (AOR = 2.07, 95% CI: 1.28–3.37) compared to the PTB+ patients. 

In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to patients from rural area is recommended.

Below:    Trend of all types of registered TB cases in Dilla University Referral Hospital, Southern Ethiopia, 2008–2013

Full article at:   http://goo.gl/LdoKvx

By:  

Gebremedhin Gebrezgabiher, Endalew Zemene

Jimma University, College of Health Sciences, P.O. Box 378, Jimma, Ethiopia

Gebremedhin Gebrezgabiher

Samara University, College of Veterinary Medicine, P.O. Box 132, Samara, Ethiopia

Gebremedhin Romha

Dilla University, College of Agriculture and Natural Resource, P.O. Box 419, Dilla, Ethiopia

Eyasu Ejeta

Wollega University, College of Health Sciences, P.O. Box 395, Nekemte, Ethiopia

Getahun Asebe

Gambella University, College of Agriculture and Natural Resource, P.O. Box 126, Gambella, Ethiopia

Gobena Ameni

Addis Ababa University, Aklilu Lemma Institute of Pathobiology, P.O. Box 1176, Addis Ababa, Ethiopia

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HAART, DOTS and Renal Disease of Patients Co-Infected with HIV/AIDS and TB in the South West Region of Cameroon

Tuberculosis is the commonest infection among HIV/AIDS patients. This co-infection constitutes a major death threat in the world. There is paucity of data about renal disease amongst patients on HAART and DOTS therapy in Cameroon.

This was a hospital-based cross-sectional study in the Buea, Limbe and Kumba government Hospitals. Spectrophotometric method was used for the quantitative determination of serum creatinine, urea, albumin and total protein levels. Glomerular filtration rate was estimated using the MDRD method. The student’s t test, ANOVA and logistic regression were used to analyse the data.

Out of 200 participants, 101 (50.5 %) were males. The ages ranged from 21 to 65 years with a mean age of 38.04 ± 10.52 years. Compared to adults on DOTS alone, adults on HAART alone had a significantly higher prevalence of eGFR <60 ml/min/1.73 m ² while more participants on HAART/DOTS had significantly higher serum creatinine (18/60 (30 %) vs 10/70 (14.3) OR = 2.57 [1.08–6.12], p = 0.033). Though participants on HAART/DOTS combined therapy had low eGFR, the association was not statistically significant (OR = 6.27, 95 % CI;0.71–55.27, p = 0.098). Participants on the Zidovudine, Lamivudine, Nevirapine regimen showed a statistically significant difference in the mean serum creatinine and albumin levels between the HAART/DOTS combined therapy and HAART group (p = 0.0219 and 0.0001 respectively).

Compared to adults on DOTS, adults on HAART were more likely to have renal dysfunction (eGFR <60 ml/min per 1.73 m ² ). Adult on a combination of HAART and DOTS had a similar prevalence of renal dysfunction as those on HAART alone. This study showed that the use of the HAART regimen (Tenofovir, Lamivudine and Efavirenz combination) among the HAART treated adults was nephrotoxic. However, other combined HAART and DOTS regimens had no nephrotoxic effect. Abnormal kidney function can be associated with HAART use.

Full article at:  http://goo.gl/ZVtGGq

By: Dickson Shey Nsagha^1*, Benjamin Thumamo Pokam², Jules Clement Nguedia Assob²,Anna Longdoh Njunda², Odette Dzemo Kibu², Elvis Asangbeng Tanue², Charlotte Wenze Ayima² and Patrick Elroy Weledji³

¹Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon

²Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon

³Department of Surgery, Obstetrics and Gynaecology, Faculty of Health Sciences, University of Buea, Buea, Cameroon

  

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