Treatment default among pulmonary tuberculosis patients at an urban slum in South-Eastern Nigeria

Authors

  • Ndubuisi O. Nwachukwu Department of Microbiology, Abia State University, Uturu, Nigeria
  • Azu R. Onyeagba Department of Microbiology, Abia State University, Uturu, Nigeria
  • Elendu C. Onwuchekwa Department of Microbiology, Abia State University, Uturu, Nigeria
  • Okoronkwo C. Uche Department of Microbiology, Abia State University, Uturu, Nigeria
  • Ulasi A. Esther Department of Animal and Environmental Biology, Abia State University, Uturu, Nigeria

DOI:

https://doi.org/10.18203/2320-6012.ijrms20172994

Keywords:

Anambra State, Pulmonary tuberculosis, Reasons, Treatment default

Abstract

Background: Anambra State is one of the States in Nigeria with a high rate of treatment default. The objectives were to examine default from treatment among newly diagnosed pulmonary tuberculosis patients and identify reasons for default.

Methods: This prospective observational study was conducted at Okpoko in Ogbaru local government area of Anambra state. A total of 166 patients participated. Diagnosis of pulmonary tuberculosis was based on microscopy. Patients were treated using the standard 6-month regimen recommended by WHO.

Results: A treatment default rate of 13.3% was observed. Default was higher in males (15.7%) and in patients aged < 35 years old (P<0.05). Exactly 9 (13.8%) defaulters lived >5km radius from treatment centers versus 3 (12.9%) who lived <5km radius from treatment centers (P<0.05). Majority of patients 17 (77.3%) defaulted during the continuation phase of treatment. The main reasons for default were attributed to harsh attitude of care providers (59.1%), resolution of symptoms (54.5%) migration (36.4%) and poverty (36.4%).

Conclusions: Treatment default was high (13.3%) and majority of patients defaulted during the continuation phases. Periodic supervision of community care providers and enhanced counselling of young patients will reduce patient default from treatment.

Author Biographies

Ndubuisi O. Nwachukwu, Department of Microbiology, Abia State University, Uturu, Nigeria

Department of Microbiology and Lecturer (Ph.D)

Azu R. Onyeagba, Department of Microbiology, Abia State University, Uturu, Nigeria

Department of Microbiology, Professor

Elendu C. Onwuchekwa, Department of Microbiology, Abia State University, Uturu, Nigeria

Department of Microbiology, Ph.D

Okoronkwo C. Uche, Department of Microbiology, Abia State University, Uturu, Nigeria

Department of Microbiology, Ph.D

Ulasi A. Esther, Department of Animal and Environmental Biology, Abia State University, Uturu, Nigeria

Department of Animal and Environmental Biology, MSc

References

Ifebunandu NA, Ukwaja KN. Tuberculosis treatment default in a large tertiary care hospital in urban Nigeria: prevalence, trend, timing and predictors. Int J Infect Pub Health. 2012;5:340-5.

Jaggarajamma K, Sudha G, Chandrasekaran V, Nirupa C, Thomas A, Santha T, et al. Reasons for non-compliance among patients treated under revised national tuberculosis control programme (RNTCP), Tiruvallur district, South India. Indian J Tuberc. 2007;5:130-5.

Sharma SK, Mohan A. Multi-drug resistant tuberculosis: a menace that threatens to destabilize tuberculosis control. Chest. 2006;130:261-72.

Borgdorff MW, Floyd K, Broekmans JF. Interventions to reduce tuberculosis mortality and transmission in low-and-middle-income countries. Bull World Health Organ. 2002;80:217-27.

Federal Ministry of Health, Nigeria. National Tuberculosis and Leprosy Control Programme, Workers Manual. Revised 5th Ed. 2010;1-119.

World Health Organization. Definitions and reporting framework for tuberculosis. WHO: 2013;2013 revision. Geneva. Available at http://www.who.int/tb/publications/definitions/en/.

Ukwaja KN, Aloba I, Ifeabunandu NA, Osakwe PC. Trend in case detection rate for all tuberculosis cases notified in Ebonyi, South-eastern Nigeria during 1999-2009. Pan Afr Med J. 2013;16:11.

National Tuberculosis and Leprosy Control Programme, Report of 2012 National tuberculosis prevalence survey, Federal Ministry of Health Abuja, Nigeria; 2013

National Tuberculosis and Leprosy Control Programme Report, The National Strategic Plan for Tuberculosis Control, Towards Universal Access to Prevention, Diagnosis and Treatment 2015-2020, Nigeria; 2016:55-70

Akinola AF, Abimbola SO, Afolabi EB. Treatment outcomes among pulmonary tuberculosis patients at treatment centres in Ibadan, Nigeria. Ann Afr Med. 2009;8:100-4.

Amoran OE, Osiyale OO, Lawal KM. Pattern of default among tuberculosis patients on directly observed therapy in rural primary health care centres in Ogun State, Nigeria. J Infect Dis Immun. 2011;3:90-5.

Alobu I, Oshi SN, Oshi DC, Ukwaja KN. Risk factors of treatment default and among tuberculosis patients in a resource-limited setting. Asian Pac J Trop Med. 2014;977-84.

Dodor EA, Tuberculosis treatment default at the communicable diseases unit of Effia-Nkwanta Regional Hospital: a 2 years’ experience. Int J Tuberc Lung Dis. 2004;8:1337-41.

World Health Organization, Adherence to long-term therapies; Evidence for action 2003;1:11-15. Available at http://apps.who.int/medicinedocs/en/d/Js4883e/7.2.html.

UN-HABITAT, The State of African Cities report. United Nations Human Settlement Programme, (UN-HABITAT); 2008.

World Health Organization, framework for implementing new tuberculosis diagnosis. Geneva, Switzerland; 2010.

World Health Organization, Treatment off tuberculosis: guidelines for National programmes, 3rd ed, WHO/CDS/TB/2003. 2003:313

Nwachukwu ON, Onyeagba RA, Nwaugo VO, Okafor A. Treatment outcomes of new smear positive pulmonary tuberculosis patients under directly observed treatment in Anambra State, Nigeria. Pulm Crit Care. 2017;2:1-4.

Firdie T, Tariku D, Tsegaye T. Treatment outcomes of tuberculosis patients at Debre Berham hospital, Anambra Region, Northern Ethiopia. Ethiopian J Health Sci. 2016;26:65-72.

Dodor EA, Afenyadu GY. Factors associated with TB treatment default and completion at the Effia-Nkwanta regional hospital in Ghana. Trans R Soc Trop Med Hyg. 2005;99:827-32.

Muture BN, Keraka MN, Kimuu PK, Kabiru EW Ombeka V, Oguya F. Factors associated with default from treatment among tuberculosis patients in Nairobi province Kenya: a cases control study. BMC Public Health. 2011;11:696.

Pefura EW, Kengne AP, Kuaban C. Incidence, time and determinants of tuberculosis treatment default in Yaounde, Cameroon: a retrospective hospital register-based cohort study. BMC Open. 2011;1:e000289.

Adinma ED, Iloghalu IC, Azuike EC, Obi DC, Mbanuzuru VA, Nwabueze SA et al. Outcome of tuberculosis treatment in tertiary hospital in Southeast Nigeria. Int Inv J Med Sci. 2015;2:17-22.

Daniel OJ, Oladapo OT, Alasa OK. Default from treatment programme in Sagamu, Nigeria. Nigerian J Med. 2006;15:63-7.

Barn TS, Gunreberg C, Chamrounsawasdi K, Bam DS, Aslberg O, Kasland O et al. Factors affecting patient adherence DOTS in urban Kathmarah. Int J Tuberc Lung Dis. 2006;10:270-6.

Shargie EB, Lindtjorn B. Determinants of treatment adherence among smear-positive tuberculosis patients in Southern Ethiopia. PLOS Med. 2007;4:e2807.

Abuaku B, Tan H, Li X, Chen M, Huang X. Treatment default and death among tuberculosis patients on Hunan, China. Scand J Infect Dis. 2010;42:281-7.

Castelnuovo B. A review of compliance to anti-tuberculosis treatment and risk factors for defaulting in Sub-Sahara Africa. Afr Health Sci. 2010;10:320-4.

Tachfouti N, Slama K, Berraho M, Elfakir S, Benjelloun MC, El Rhazi et al. Determinants of tuberculosis treatment default in Morocco: results from a national cohort study. Pan Afr Med. 2013;14:21.

Rutherford ME, Hill PC, Maharani W, Sampumo H, Ruslami R. Risk factors for treatment default among adult tuberculosis patients in Indonesia. Int J Tuberc Lung Dis. 2013;17:1304-9.

Jenkins HE, Ciobanu A, Plesca V, Crudu V, Galusca I, Soltan V, et al. Risk factors and timing of default from treatment for non-multidrug-resistant tuberculosis in Moldova. Int J Tuberc Lung Dis. 2013;17:373-80.

Kruk ME, Schwalbe NR, Aguiar CA. Timing of default from tuberculosis treatment: systematic review. Trop Med Int Health. 2008;13:703-12.

Pronab C, Bratati B, Debashish D, Rama RP, Ashok KM. A comparative evaluation of factors and reasons for defaulting in tuberculosis treatment in the States of West Bengal, Jharkhand and Arunachal Pradesh. Indian J Tuberc. 2003;50:17-21.

International Union Against Tuberculosis and Lung Diseases. Best Practice for the care of patients with tuberculosis. USAID; 2017;51.

Downloads

Published

2017-06-24

How to Cite

Nwachukwu, N. O., Onyeagba, A. R., Onwuchekwa, E. C., Uche, O. C., & Esther, U. A. (2017). Treatment default among pulmonary tuberculosis patients at an urban slum in South-Eastern Nigeria. International Journal of Research in Medical Sciences, 5(7), 3098–3102. https://doi.org/10.18203/2320-6012.ijrms20172994

Issue

Section

Original Research Articles