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Factors associated with poor tuberculosis treatment outcome in the Southern Region of Ethiopia.

SETTING
Tuberculosis (TB) treatment centres in southern Ethiopia.


OBJECTIVES
To describe the outcomes of patients registered for anti-tuberculosis treatment and to identify factors associated with poor treatment outcome.


DESIGN
Retrospective audit of patients registered from 2002 to 2007. Patients were categorised as having successful (cured or completed treatment) or poor treatment outcome (failed treatment, defaulted or died). Logistic regressions were used to identify risk factors for poor outcome.


RESULTS
A total of 6547 patients (55.6% male, 44.4% female) with a mean age of 27.5 years were registered for treatment; 2873 (43.9%) were smear-positive, 2493 (30.1%) smear-negative and 1157 (17.7%) had extra-pulmonary TB. Most (n = 6033, 92%) were new cases; 4900 (74.8%) had a successful and 1095 (16.7%) a poor treatment outcome. Of those with a poor outcome, 667 (60.9%) patients defaulted, 404 (36.9%) died and 24 (2.2%) failed treatment. Attending the regional capital health centre (aOR 2.09, 95%CI 1.85-2.69), being on retreatment (aOR 2.07, 95%CI 1.47-2.92), having a positive smear at the second month follow-up (aOR 1.68, 95%CI 1.07-2.63), having smear-negative pulmonary TB (aOR 1.62, 95%CI 1.4-1.86), age >55 years (aOR 1.44, 95%CI 1.12-1.86) and being male (aOR 1.24, 95%CI 1.09-1.42) were independent risk factors for poor outcome.


CONCLUSION
Treatment outcome was suboptimal and targeted measures should be considered to reduce the rate of poor treatment outcome among high-risk groups.