OJEpi  Vol.6 No.1 , February 2016
Characterization of Defaulters from Tuberculosis Treatment in a Tertiary Hospital in South Eastern Nigeria
ABSTRACT
Background: Tuberculosis is second only to HIV/AIDS as the greatest killer worldwide, due to a single infectious agent. Directly Observed Treatment Short-Course (DOTS) is presently the WHO recommended programme to fight tuberculosis worldwide. There is a need to understand the characteristics of patients who default from treatment for tuberculosis. This will help modify the strategies to reduce such default to the barest minimum and achieve higher levels of adherence. Objective: The aim of this study was to describe the characteristics of patients that defaulted from treatment for TB at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi DOTS clinic for the period 1st January 2011 to 31st December 2012. Materials and Methods: This was a retrospective study conducted at the DOTS clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. The records of patients who received treatment from the clinic from 1st January 2011 to 31st December 2012 (2 years) were reviewed. The data collected include patients’ demographic characteristics, treatment category, patient type, baseline sputum smear result, and retroviral status. From the data, default rate was calculated and its relationship with other variables noted. Associations between patients’ characteristics were determined using chi square test of independence. The significance level was set at p = 0.05. Results: A total of 765 patients enrolled for TB treatment in the DOTS clinic of the study area within the study period of 1st January 2011 and December 31st 2012. The mean age at commencement of the treatment was 33.14 years (±18.09). The outcome of treatment showed that 260 (34%) had treatment completed, 230 (30.1%) cured, 120 (15.7%) defaulted, 103 (13.5%) died, 40 (5.2%) were transferred-out, and 12 (1.6%) failed in the treatment, giving a treatment success rate of 64.1%. Among the 120 (15.7%) patients that defaulted from treatment, majority 80 (66.7%) were males, and most 30 (25.0%) were in the 30 - 39 years age group. Conclusion: Defaulting starts with treatment interruption hence prompt management of interruption of treatment and default will largely help in preventing drug-resistant TB.

Cite this paper
Adinma, E. , Mbanuzuru, V. , Azuike, E. , Iloghalu, I. and Obi, D. (2016) Characterization of Defaulters from Tuberculosis Treatment in a Tertiary Hospital in South Eastern Nigeria. Open Journal of Epidemiology, 6, 1-9. doi: 10.4236/ojepi.2016.61001.
References
[1]   WHO. Global Tuberculosis Report 2014.

[2]   WHO. Global Tuberculosis Report 2013.

[3]   Federal Ministry of Health. Department of Public Health (2010) National Tuberculosis and Leprosy Control Programme (NTBLCP). Worker’s Manual. Revised 5th Edition, 11-63.

[4]   Park, K. (2007) Park’s Textbook of Preventive and Social Medicine. 19th Edition, M/s Banarsidas Bhanot Publishers, Jabalpur, 149-166.

[5]   Sunder, L.A.P. (2011) Textbook of Community Medicine—Preventive and Social Medicine. 3rd Edition, CBS Publishers & Distributors, New Delhi, 420-431.

[6]   Obionu, C.N. (2007) Primary Health Care for Developing Countries. 2nd Edition, Ezu Books, Enugu, 139-150.

[7]   Omotosho, B.A., Adebayo, A.M., Adeniyi, B.O., et al. (2014) Tuberculosis Treatment Outcomes and Interruption among Patients Assessing DOTS Regimen in a Tertiary Hospital in a Semi-Urban Area of South-Western Nigeria. Nigerian Journal of Medicine, 23, 51-56.

[8]   Getahun, B., Ameni, G., Medhin, G. and Biadgilign, S. (2013) Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment in Addis Ababa, Ethiopia. Brazilian Journal of Infectious Diseases, 17, 521-528.
http://dx.doi.org/10.1016/j.bjid.2012.12.010

[9]   Marx, F.M., Dunbar, R., Enarson, D.A. and Beyers, N. (2013) The Rate of Sputum Smear-Positive Tuberculosis after Treatment Default in a High-Burden Setting: A Retrospective Cohort Study. PLoS ONE, 8, e45724.
http://dx.doi.org/10.1371/annotation/ea5f2a13-4394-41af-84c8-3e6af4a07770

[10]   Muture, B.N., Keraka, M.N., Kimuu, P.K., Kabiru, E.W., Ombeka, V.O. and Oguya, F. (2011) Factors Associated with Default from Treatment among Tuberculosis Patients in Nairobi Province Kenya: A Case Control Study. BMC Public Health, 11, 696.
http://dx.doi.org/10.1186/1471-2458-11-696

[11]   Epco, H., Maksad, K., Shakhnoz, U., Umid, A., Umida, Y., van der Werf Marieke, J., Gulnoz, U. and Jaap, V. (2008) Default from Tuberculosis Treatment in Tashkent, Uzbekistan; Who Are These Defaulters and Why Do They Default. BMC Infectious Diseases, 8, 97.
http://dx.doi.org/10.1186/1471-2334-8-97

[12]   Kherad, O., Herrmann, F.R., Zellweger, J.P., Rochat, T. and Janssens, J.P. (2009) Clinical Presentation, Demographics and Outcome of Tuberculosis (TB) in a Low Incidence Area: A 4-Year Study in Geneva, Switzerland. BMC Infectious Diseases, 9, 217.
http://dx.doi.org/10.1186/1471-2334-9-217

[13]   Karanjekar, V.D., Lokare, P.O., Gaikwad, A.V., Doibale, M.K., Gujrathi, V.V. and Kulkarni, A.P. (2014) Treatment Outcome and Follow-Up of Tuberculosis Patients Put on Directly Observed Treatment Short-Course under Rural Health Training Center, Paithan, Aurangabad in India. Annals of Medical and Health Sciences Research, 4, 222-226.
http://dx.doi.org/10.4103/2141-9248.129047

[14]   Chennaveerappa, P.K., Jayashree, N., Nareshkumar, M.N., Praveen, G., Halesha, B.R. and Vinaykumar, M.V. (2014) TB-DOTS Outcome in Relation to HIV Status: Experience in a Medical College. Journal of Clinical and Diagnostic Research, 8, 74-76.

[15]   Atif, M., Sulaiman, S.A., Shafie, A.A., Ali, I., Asif, M. and Babar, Z.U. (2014) Treatment Outcome of New Smear Positive Pulmonary Tuberculosis Patients in Penang, Malaysia. BMC Infectious Diseases, 14, 399.
http://dx.doi.org/10.1186/1471-2334-14-399

 
 
Top