Outcome of community-initiated treatment of drug-resistant tuberculosis patients in Lagos, Nigeria

Author:

Bakare Adebayo M1,Udunze Obioha C1,Bamidele Janet O2ORCID,Omoniyi Amos3,Osman Eltayeb1,Daniel Olusoji J2

Affiliation:

1. Damien Foundation Belgium Nigeria project, Lagos State Nigeria

2. Department of Community Medicine and Primary Care, Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun State, Nigeria

3. World Health Organization, Abuja FCT, Nigeria

Abstract

Abstract Background With the improvement in the capacity to diagnose multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) patients due to the increased number of GeneXpert machines in Nigeria, the number of patients diagnosed surpassed the bed capacity at MDR-TB treatment centres. Community DR-TB treatment is an important option to improve access to care for MDR/RR-TB patients. However, few studies have determined the outcome of community management of MDR-TB patients, which this study aims to address. Methods We conducted a retrospective study of MDR/RR-TB patients initiated on treatment in the community in Lagos, Nigeria, between 1 January 2015 and 31 December 2016. Data were retrieved from DR-TB treatment cards/registers. The treatment outcomes of these patients were assessed at the end of treatment and categorized according to national TB guidelines. Results A total of 150 DR-TB patients commenced treatment during the study period. Adherence was 64.7%, with the majority of patients experiencing mild (56.5%) adverse drug events. Treatment was successful in 70% of patients. The only predictor of successful treatment was treatment adherence. Conclusions The study shows that community initiation of MDR-TB treatment is feasible and results in a high treatment success rate. Adherence counselling before and during treatment is essential for a favourable treatment outcome.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology

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