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High variability in tuberculosis treatment outcomes across 15 health facilities in a semi-urban area in central Ethiopia

Zenatti, Giuseppe ; Raviglione, Mario ; Tesfaye, Fregenet LU ; Bobosha, Kidist ; Björkman, Per LU orcid and Walles, John LU orcid (2023) In Journal of Clinical Tuberculosis and Other Mycobacterial Diseases 30.
Abstract

Background: Despite reported tuberculosis (TB) treatment success rate of 86%, TB remains a leading cause of death in Ethiopia. We investigated patient and provider-specific factors associated with unfavorable treatment outcomes in Ethiopian health facilities providing TB care. Methods: Data on characteristics and treatment outcomes of patients registered for TB treatment at 15 public health facilities (4 hospitals and 11 health centres) were collected from clinic registers. Proportions of unfavorable outcomes (defined as deaths, loss-to-follow-up [LTFU] and treatment failure), were compared across facilities using multivariable logistic regression, with separate analyses for death and LTFU. Results: Among 3359 patients (53.5 % male,... (More)

Background: Despite reported tuberculosis (TB) treatment success rate of 86%, TB remains a leading cause of death in Ethiopia. We investigated patient and provider-specific factors associated with unfavorable treatment outcomes in Ethiopian health facilities providing TB care. Methods: Data on characteristics and treatment outcomes of patients registered for TB treatment at 15 public health facilities (4 hospitals and 11 health centres) were collected from clinic registers. Proportions of unfavorable outcomes (defined as deaths, loss-to-follow-up [LTFU] and treatment failure), were compared across facilities using multivariable logistic regression, with separate analyses for death and LTFU. Results: Among 3359 patients (53.5 % male, median age 28 years, 19.6 % HIV-positive), 296 (8.8 %) had unfavorable treatment outcome. Proportions of unfavorable outcomes across facilities ranged from 2.0 % to 21.1 % (median 8.3 %). Median proportions of death and LTFU among facilities were 3.3 % (range 0–10.9 %) and 2.6 % (range 0.6 %-19.2 %), respectively. Three facilities had significantly higher rates of LTFU, whereas two facilities had higher rates of death. The two facilities with full-time TB-nurses had higher proportions of successful outcomes (95.2 % vs 90.1 %, adjusted odds ratio 2.27, p < 0.0001). Conclusion: Substantial variability of TB treatment outcomes was observed across the assessed health facilities providing TB care, independently of age and HIV co-infection, reflecting possible differences in service structure and related quality of care.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Africa, Ethiopia, Health facilities, Treatment outcome, Tuberculosis, Tuberculosis treatment
in
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
volume
30
article number
100344
publisher
Elsevier
external identifiers
  • pmid:36578805
  • scopus:85145679420
ISSN
2405-5794
DOI
10.1016/j.jctube.2022.100344
language
English
LU publication?
yes
id
1a4ccd66-a479-4b32-bc86-e48644dade27
date added to LUP
2023-02-09 15:06:34
date last changed
2024-04-16 07:36:16
@article{1a4ccd66-a479-4b32-bc86-e48644dade27,
  abstract     = {{<p>Background: Despite reported tuberculosis (TB) treatment success rate of 86%, TB remains a leading cause of death in Ethiopia. We investigated patient and provider-specific factors associated with unfavorable treatment outcomes in Ethiopian health facilities providing TB care. Methods: Data on characteristics and treatment outcomes of patients registered for TB treatment at 15 public health facilities (4 hospitals and 11 health centres) were collected from clinic registers. Proportions of unfavorable outcomes (defined as deaths, loss-to-follow-up [LTFU] and treatment failure), were compared across facilities using multivariable logistic regression, with separate analyses for death and LTFU. Results: Among 3359 patients (53.5 % male, median age 28 years, 19.6 % HIV-positive), 296 (8.8 %) had unfavorable treatment outcome. Proportions of unfavorable outcomes across facilities ranged from 2.0 % to 21.1 % (median 8.3 %). Median proportions of death and LTFU among facilities were 3.3 % (range 0–10.9 %) and 2.6 % (range 0.6 %-19.2 %), respectively. Three facilities had significantly higher rates of LTFU, whereas two facilities had higher rates of death. The two facilities with full-time TB-nurses had higher proportions of successful outcomes (95.2 % vs 90.1 %, adjusted odds ratio 2.27, p &lt; 0.0001). Conclusion: Substantial variability of TB treatment outcomes was observed across the assessed health facilities providing TB care, independently of age and HIV co-infection, reflecting possible differences in service structure and related quality of care.</p>}},
  author       = {{Zenatti, Giuseppe and Raviglione, Mario and Tesfaye, Fregenet and Bobosha, Kidist and Björkman, Per and Walles, John}},
  issn         = {{2405-5794}},
  keywords     = {{Africa; Ethiopia; Health facilities; Treatment outcome; Tuberculosis; Tuberculosis treatment}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Clinical Tuberculosis and Other Mycobacterial Diseases}},
  title        = {{High variability in tuberculosis treatment outcomes across 15 health facilities in a semi-urban area in central Ethiopia}},
  url          = {{http://dx.doi.org/10.1016/j.jctube.2022.100344}},
  doi          = {{10.1016/j.jctube.2022.100344}},
  volume       = {{30}},
  year         = {{2023}},
}