Department of Community Medicine, Delta State University, Abraka, Nigeria.
Department of Community Health, Ambrose Alli University, Ekpoma, Edo State Nigeria.
Afr Health Sci. 2022 Jun;22(2):169-177. doi: 10.4314/ahs.v22i2.20.
The objective of this study is to observe the trend in treatment outcomes and identify determinants of treatment success among patients recruited into care through the DOTS strategy.
A retrospective record review of tuberculosis patients (2012-2016) was carried out at the Tuberculosis and Leprosy Referral Centre, Eku, Delta State, Nigeria.
Records of four hundred and twenty five (425) tuberculosis patients under DOTS were reviewed over five years. The highest number of cases under treatment, 102 (24.0%), was recorded in 2013. The mean age (SD) of patients was 37.3 (±16.5) years, majority of the patients were male (62.4%) and 18% had TB/HIV co-infection. Treatment outcomes of patients were cured (53.4%), completed (27.8%), died (6.8%), failed (2.4%), lost to follow up (4.9%), transferred out (1.2%) and not evaluated (3.5%). Over all, treatment success rate was 81.2% with a trend of 88.7% (2012), 87.3% (2013), 85.9% (2014), 65.0% (2015) and 65.8% (2016) respectively. Patient characteristics were not associated with treatment success.
The treatment success rate was high and in line with the national recommendation of 80% and above. The trend showed a reduction in number of new cases enrolled into the DOTS programme, reduction in success rate with a concomitant increase in loss to follow up. There was no association between patient characteristics and TB treatment success. System strengthening on patient follow up, community health education and treatment adherence is recommended.
本研究旨在观察通过 DOTS 策略纳入治疗的患者的治疗结果趋势,并确定治疗成功的决定因素。
对尼日利亚三角洲州埃库结核病和麻风病转诊中心(Tuberculosis and Leprosy Referral Centre, Eku)2012-2016 年的结核病患者(425 例)进行了回顾性病历审查。
五年内共审查了 425 例接受 DOTS 治疗的结核病患者的记录。2013 年治疗的病例数最多,为 102 例(24.0%)。患者的平均年龄(标准差)为 37.3(±16.5)岁,大多数为男性(62.4%),18%合并 HIV/TB 感染。患者的治疗结局为治愈(53.4%)、完成(27.8%)、死亡(6.8%)、失败(2.4%)、失访(4.9%)、转出(1.2%)和未评估(3.5%)。总体而言,治疗成功率为 81.2%,呈上升趋势,分别为 88.7%(2012 年)、87.3%(2013 年)、85.9%(2014 年)、65.0%(2015 年)和 65.8%(2016 年)。患者特征与治疗成功无关。
治疗成功率较高,符合国家建议的 80%及以上标准。趋势显示,新纳入 DOTS 项目的病例数减少,成功率降低,同时失访率增加。患者特征与结核病治疗成功之间没有关联。建议加强患者随访、社区健康教育和治疗依从性。