DETERMINING TUBERCULOSIS (TB) TREATMENT OUTCOME AND FACTORS INFLUENCING THE TB TREATMENT OUTCOME IN THE OBUASI MUNICIPALITY OF THE ASHANTI REGION OF GHANA

Abstract

Tuberculosis (TB) is one of the world‟s most deadly communicable diseases that threatens public health globally and mostly affects persons in their productive lives. The burden of tuberculosis and its determinants are key identifiers to a successful TB management system. Retrospective study using both primary and secondary data was conducted to determine the TB case profile and factors that influence TB treatment outcome in the Obuasi Municipality from 1st January 2009 to 31st December 2014 to inform on case characteristics to improve on TB management. A total of 1,347 registered tuberculosis cases were reviewed in three (3) treatment centres in the Obuasi municipality from 2009 to 2014. The male to female ratio was 3:1 with 95.6% (1288/1347) of the cases being pulmonary and 4.4% (59/1347) extra-pulmonary tuberculosis. The pulmonary tuberculosis cases consisted of 58.9% (759/1288) and 41.1% (529/1288) sputum positive and sputum negative respectively. The treatment evaluation of the cases showed that 573 (42.5%) were cured, 441 (32.7%) completed treatment, 115 (8.5%) defaulted treatment, 110 (8.2%) died, 87 (6.5%) were transferred out, 3 (0.2%) had treatment failure and 18 (1.3%) were not evaluated. This then gave a treatment success rate of 75.2% (1014/1347). The treatment success rate of 75.2% was lower than the Ghana average for 2011 of 86.5% and WHO target of 85%. For the study involving the use of data, a total of 243 respondents were interviewed, giving a response rate of 84.7% (243/287). Of the 243 respondents, (74.9% male, 25.1% female) and 159 (65.4%) of them were treated as smear positive pulmonary TB, 78 (32.1%) were treated as smear negative pulmonary TB and 6 (2.5%) were treated as extrapulmonary TB. The treatment outcome of the 243 respondents showed that 132 (54.3%) were cured, 87 (35.8%) completed treatment and 24 (9.9%) defaulted treatment. Respondents travelled between 5km to 20km to access TB services and collect TB drugs. Of the respondents, 134 (55.1%) had treatment supporters and 109 (44.9%) did not have treatment supporters. Also, the respondents spent between GHS 1 to GHS 30 or more any day they (patient or treatment supporter) visited the treatment centres for TB drugs as transportation and other related cost. TB treatment should be decentralized to many of the health facilities and community levels to avoid long travelling distances. All TB patients must be encouraged to have treatment supporters‟ especially encouraging families to support the TB patients during their treatment to ensure compliance to treatment. Health education on emphasis for treatment compliance and treatment duration should be encouraged and must be done to the level of the patients for easy understanding and compliance. Supervision and contact tracing must be enhanced to improve on case detection and treatment success.