Factors associated with tuberculosis treatment success rates in Kalungu District

Abstract

Introduction Tuberculosis (TB) treatment success rate (TSR) is an indicator of the quality of TB treatment programs. To end the TB pandemic, it is crucial to scrutinize the TSR determinants especially in the mostly rural high HIV prevalence areas, like Kalungu district which has reported low TSR over the years.

Objective To assess the determinants of TB TSR in 2023 in Kalungu district to inform TB treatment strategies.

Methods A cross-sectional design was used and the outcome variable was TB TSR in 2023. Patients 18 years and above diagnosed with drug susceptible TB, with treatment outcomes documented in Kalungu in 2023 were included. A total of 385 patients were sampled and health facilities were selected by stratified sampling. Data were collected from facility records and patient interviews and analyzed using Stata version 14. TB TSR was computed using proportions, and modified Poisson regression with robust standard errors was used for bivariate and multivariable analyses.

Results The study included 385 participants, with a median age of 40 years (IQR: 31-53). Majority, 53.8% (n=207) were males and 60.3% (n=232) had HIV coinfection, slightly above the district’s 56%. The TB TSR was 75.6% (95%CI: 71.0%-79.6%) with 96 (24.9%) patients cured and 195 (50.7%) completed. Males had 15% lower likelihood [aPR = 0.85, 95%CI: (0.76-0.96)] of TSR compared to females. Patients with formal education had higher prevalence of TSR than those without [primary: aPR = 1.31, 95%CI: (1.08-1.59); secondary: aPR = 1.32, 95%CI: (1.05-1.67); tertiary: aPR = 1.48, 95%CI (1.16-1.89)].

Conclusion TB TSR in Kalungu district is considerably below the national average (89.4%) and the WHO target (90%). Males were associated with lower treatment success while formal education facilitated the contrary. The district health team and facility health workers are urged to enhance support for males on treatment and devise strategies of better health education for patients without formal education.