Determinants of an unfavorable treatment outcome among tuberculosis patients in the Jimma Zone, Southwest Ethiopia

埃塞俄比亚西南部吉马地区结核病患者治疗效果不佳的决定因素

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Abstract

Tuberculosis (TB) is a major public health challenge in Ethiopia. TB treatment outcomes were suboptimal compared to the expected target of the national TB control Program. The provision of standard anti-TB treatment is the primary component of the directly observed treatment, short-course strategy. The aim of this study was to assess the TB treatment outcomes and the determinants of an unfavorable treatment outcome. The study used a cross-sectional study design at baseline and record review to identify treatment outcomes. A total of 1,161 TB patients were recruited from eight randomly selected districts and one town administration in the Jimma Zone, Ethiopia. Treatment outcomes were grouped into favorable and unfavorable. Of the total participants, 86.9% had a favorable treatment outcome, and 5.7% an unfavorable treatment outcome. The rest were transferred out and not recorded cases. Women were more likely to experience an unfavorable treatment outcome [adjusted odds ratio (AOR) = 1.96, 95% CI 1.06, 3.64]. Patients who were perceived to not be stigmatized were less likely to have an unfavorable treatment outcome (AOR = 0.32, 95% CI 0.15, 0.73). Patients who had a monthly income of > 3,500 Ethiopian birr were less likely to have an unfavorable outcome than patients who did not have a regular income (AOR = 0.04, 95% CI 0.01, 0.45). The observed treatment success rate is lower than the World Health Organization's target of successfully treating > 90% of detected TB cases. It is imperative to ensure that information, education and communication/behavior change communication strategies consider the needs of women and patients with perceived TB stigma. Furthermore, designing locally acceptable and affordable interventions may help to address the financial challenges of TB treatment adherence.

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