RESUMO
Background: Despite the availability of effective medications, tuberculosis (TB) continues to be a serious global public health problem, primarily affecting low and middle-income nations. Measuring and reporting TB treatment outcomes and identifying associated factors are fundamental parts of TB treatment. The goal of this study was to look at the outcomes of TB treatment and the factors that influence them in Sekota, Northeast Ethiopia. Materials and Methods: A facility-based retrospective study was conducted in Tefera Hailu Memorial General Hospital, Sekota town, Northeast Ethiopia. All TB patients who registered in the TB log book and had known treatment outcomes at the treatment center between January 1, 2015, and December 30, 2021, were included in this study. The data was gathered utilizing a pretested structured data extraction format that comprised demographic, clinical, and treatment outcome characteristics. Data were entered, cleaned, and analyzed using SPSS version 25. Descriptive statistics and logistic regression analysis were employed. A p value of less than 0.05 was considered statistically significant. Results: A total of 552 registered TB patients' data were reviewed. Of these, 49.6% were male, 94.4% were new cases, 64.9% were presented with pulmonary TB, and 18.3% were HIV positive. Regarding the treatment outcome, 11.6% were cured, 82.2% completed their treatment, 1.1% had failed treatment, 1.3% were lost to follow-up, and the remaining 3.8% died during the follow-up. The overall treatment success rate among TB patients was 93.8%. The maximum number of successful treatment outcomes was 94.9% in 2021, while the lowest was 86.7% in 2020. The pattern of successful treatment results changes with the number of years of treatment. In the current study, being a new TB patient (AOR = 1.75, 95% CI: 1.31-7.32) and being an HIV-negative patient (AOR = 2.64, 95% CI: 1.20-5.8) were factors independently associated with a successful treatment outcome. Conclusion: The rate of successful TB treatment outcomes in the current study was satisfactory. This achievement should be maintained and enhanced further by developing effective monitoring systems and educating patients about medication adherence.
RESUMO
BACKGROUND: Antiretroviral treatment has played a pivotal role in the reduction of HIV/AIDS-related morbidity and mortality. However, treatment options can be impaired by the development of antiretroviral treatment failure. Regular monitoring of the Human Immunodeficiency Virus treatment outcome via viral load tests is the key approach. There is a scarcity of information about HIV treatment failure and risk factors in the study area. Therefore, the study was aimed to assess antiretroviral treatment failure and associated factors among patients on first-line antiretroviral treatment at Tefera Hailu Memorial Hospital, Sekota, northeast Ethiopia. METHODS: A hospital-based cross-sectional study was conducted on 295 patients on first-line antiretroviral treatment from Nov. 2018 to Apr. 2019. Socio-demographic and clinical variables were collected using a pretested questionnaire, and blood specimen was collected for PCR viral load and CD4 + cell count estimation. Data were entered into Epi-Info and exported to SPSS for analysis. A binary logistic regression model was used to identify associated factors, and P value < 0.05 was considered as statistically significant. RESULTS: Of the 295 subjects on first-line ART, 49 (16.6%) and 18 (6.1%) experienced virological and immunological failures, respectively. The failure of the former was associated with poor adherence (AOR: 6.367, P < 0.001), CD4 + count < 500 cells/µL (AOR: 4.78, P = 0.031) and shorter (6-24 months) duration on ART (AOR: 0.48, P = 0.048), while poor treatment adherence (AOR: 11.51, P = 0.012) and drug interruption (AOR: 6.374, P = 0.039) were the independent risk factors for latter. Immunological tests to predict virological failures showed as sensitivity, specificity, PPV, and NPV were 20.4%, 96.7%, 55.5%, and 86.0%, respectively. CONCLUSIONS: The rate of ART failure was considerably high. Poor adherence, low CD4 + count, prolonged ART, and drug interruption were found to be the most predictor variables for virological and immunological failures. The discrimination power of the immunological parameter was low in comparison to virological measurements as standard methods. Therefore, the study highlighted the need for more attention and efforts to curb associated factors and maximize virological tests for monitoring treatment failures.
