Five year review of treatment outcome of Directly Observed Therapy (DOT) for re-treatment pulmonary tuberculosis patients in UCH, Ibadan, Nigeria

Abstract

Tuberculosis (TB) is a major health problem in Nigeria. The country is currently fourth among the 22 highburden countries (HBCs) of the world, with an incident of all new cases of 311/100,000 population per year out of which 137/100,000 population are smear positive and prevalence of 616/100,000 population. To highlight the burden of re-treatment smear positive pulmonary TB with and without HIV infection and determine how Directly Observed Therapy (DOT) using the retreatment regimen has affected the treatment outcome in the management of these patients. A Five-year retrospective study from April 2003 to March 2008 to evaluate the treatment outcome data of re-treatment pulmonary TB who were also screened and confirmed for HIV at the outpatient clinic of the University College Hospital Ibadan, Nigeria. The effect of HIV status and treatment outcome was assessed so also the prevalence of HIV among recurrent PTB patients. The total number of cases assessed was 127. Majority of the patients were between the ages of 20 to 49(73.2%). Forty-two of the PTB patients were HIV positive (33.1 %). The treatment outcome was as follows: Cured 81(63.8); Treatment completed 13(10.2%); Died 22(17.3%); Defaulted four (3.1 %) and transferred out seven (5.5%) More patients were cured and had treatment completion among the HIV negative patients compared with HIV positive patients (p<0.0001) The mortality was higher in those with HIV positive than negative patients (p<0.0001). Re-treatment pulmonary TB is frequent at this referral center. A contribution to re-treatment prevention entails more rigorous management of new TB cases, particularly at lower levels of care. This effort will reduce the emergence of multi-drug resistant (MDRTB) tuberculosis