Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Federal Medical Centre, Owo, Nigeria.
Trop Med Int Health. 2020 Oct;25(10):1261-1270. doi: 10.1111/tmi.13467. Epub 2020 Aug 10.
To determine the treatment success rate among TB patients and associated factors in Anambra and Oyo, the two states with the largest burden of tuberculosis in Nigeria.
A health facility record review for 2016 was conducted in the two states (Anambra and Oyo). A checklist was used to extract relevant information from the records kept in each of the selected DOTS facilities to determine TB treatment success rates. Treatment success rate was defined as the proportion of new smear-positive TB cases registered under DOTS in a given year that successfully completed treatment, whether with bacteriologic evidence of success ('cured') or without ('treatment completed'). Treatment success rate was classified into good (≥85%) and poor (<85%) success rates using the 85% national target for TB treatment outcome. Data were analysed using descriptive statistics and chi-square at P < 0.05.
There were 1281 TB treatment enrollees in 2016 in Anambra and 3809 in Oyo (total = 4835). An overall treatment success rate of 75.8% was achieved (Anambra-57.5%; Oyo-82.0%). The percentage cure rates were 61.5% for Anambra and 85.2% for Oyo. Overall, only 28.6% of the facilities in both states (Anambra-0.0%; Oyo-60.0%) had a good treatment success rate. More facilities in Anambra (100.0%) than Oyo (40.0%) had a poor treatment success rate (p < 0.001), as did more private/FBO (100.0%) than public health facilities (60.0%) (p = 0.009). All tertiary facilities had a poor treatment success rate followed by 87.5% of secondary health facilities and 56.5% of primary healthcare facilities (P = 0.035).
Treatment success and cure rates in Anambra state were below the 85.0% of the recommended target set by the WHO. Geographical location, and level/tier and type of facility were factors associated with this. Interventions are recommended to address these problems.
确定尼日利亚结核病负担最重的两个州——阿南布拉州和奥约州的结核病患者的治疗成功率及其相关因素。
对这两个州（阿南布拉州和奥约州）2016 年的医疗机构记录进行了回顾。使用检查表从选定的 DOTS 机构保存的记录中提取相关信息，以确定结核病治疗成功率。治疗成功率定义为当年在 DOTS 下登记的新涂阳肺结核病例中成功完成治疗的比例，无论是否有细菌学成功证据（“治愈”）或无（“治疗完成”）。根据国家结核病治疗结果的 85%目标，治疗成功率被分为良好（≥85%）和不良（<85%）。使用描述性统计和 χ2 检验（P<0.05）进行数据分析。
2016 年，阿南布拉州有 1281 名结核病治疗登记患者，奥约州有 3809 名（总计 4835 名）。总体治疗成功率为 75.8%（阿南布拉州 57.5%；奥约州 82.0%）。阿南布拉州的治愈率为 61.5%，奥约州为 85.2%。总体而言，两个州只有 28.6%的机构（阿南布拉州 0.0%；奥约州 60.0%）的治疗成功率良好。阿南布拉州的设施（100.0%）比奥约州（40.0%）有更多的不良治疗成功率（p<0.001），私立/FBO 机构（100.0%）比公立卫生机构（60.0%）更多（p=0.009）。所有三级设施的治疗成功率均较差，其次是 87.5%的二级卫生设施和 56.5%的初级保健设施（P=0.035）。
阿南布拉州的治疗成功率和治愈率低于世卫组织推荐的 85.0%目标。地理位置、机构的级别/类型与地理位置是与这一结果相关的因素。建议采取干预措施来解决这些问题。
