Possible Risk Factors Associated with Tuberculosis Treatment Failure Among Patients Attending Tuberculosis Treatment Centers in Kano State, Nigeria

Fatihu A. R.; Binta M. A.; Nabila A. A.

doi:10.37591/rrjomv.v13i2.3263

Abstract

The widespread failure of tuberculosis chemotherapy has led to an increase in mortality and morbidity associated with tuberculosis infection. This study was aimed at assessing the possible risk factors associated with tuberculosis treatment failure in patients attending Aminu Kano Teaching Hospital (AKTH) and Infectious Disease Hospital (IDH), Kano State. Treatment outcomes of the 436 tuberculosis patients attending selected hospitals in 2018 were obtained using a retrospective study (review of the medical record). In 2019 consented subjects on TB treatment from the hospital (187 from AKTH and 213 from IDH) were randomly selected and followed up for 5 months to assess the cure and treatment failure rate. A structural questionnaire was employed to document clinical information, sociodemographic data, and other pertinent details. Tuberculosis-positive patients were confirmed by microscopic examination of sputum using Ziehl–Neelsen staining techniques. Subjects with Acid Fast Bacilli positive sputum after 5 months with or without clinical symptoms were considered to have treatment failure. The tuberculosis and drug resistance status of the subjects were confirmed using the GeneXpert System. Of the total number of 400 subjects enrolled (78.5%) had adequate treatment response and (21.51%) had treatment failure based on retrospective and prospective information. Up to (65.1%) of subjects with treatment failure were found to be Rifampicin sensitive and (34.9) were Rifampicin resistant p>0.05. Tuberculosis treatment failure rate was found to be significantly different between widows (53.8%), students (36.0%), primary level of education (73.5%), and between tuberculosis subjects with HIV (28.2%) when compared to subjects with tuberculosis only (p<0.05). Tuberculosis treatment failure was also found to be more common among males (23.9%) than females (19.33%), age group (0-9) years (75.0%), and among subjects with diabetes mellitus (30%), cigarette smokers (22.7%), those taking care by their families (30%) and poor adherence to treatment (47.4%) p>0.05. This study revealed that some factors such as marital status, occupation, western educational level, and HIV status, can predispose individuals to fail treatment and consequently increase the risk of developing drug resistance in a population. Therefore, special attention should be given to this high-risk group during TB treatment in the study area.

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