Abstract
Background: Tuberculosis (TB) is one of the major causes of deaths in South Africa. Therefore, monitoring its medication outcomes is significant to investigate treatment efficiency and management. To evaluate the influences on TB therapy outcomes was the aim, (defaulted, died, failed, successful, and unsuccessful) and the relationship between these factors at Mamelodi Townships, Gauteng (Tshwane). The overall hypothesis was that there are demographic factors (age, TB-case category, (human immune virus) HIV status, employment status, marital status, and location) that influence TB treatment outcomes in Mamelodi Townships.
Objective: To assess and determine factors associated with poor pulmonary TB treatment outcomes in Mamelodi Township communities between 2013 and 2017 inclusive.
Methods: The researcher conducted a retrospective analysis of data for the period between 2013 and 2017 (inclusive). An electronic Random Number Generator system was effected to produce 499 random numbers from 2011 records of participants who met the requirements from the National Health Laboratory Service (NHLS) CDW FM10069 database. Duplicate numbers were not allowed. Criteria was on location (Holani C/Itsoseng clinic, Mamelodi hospital / West clinic, Phahameng clinic and Stanza B CHC / 11 clinic), marital status, age, employment status, level of education, HIV status and TB case category. Lung TB cases older than 18 years of age with a recorded pre-treatment smear result, on anti-TB treatment, and treatment outcomes over five years period. Multivariate logistic regressions were performed in SPSS version 26 to evaluate the association between treatment results and sociodemographic variables and some clinical variables.
Results: The total number of successful treatment were 85.6%; additionally, the mortality rate (2.6%) was lower than the WHO target of three percent. Those aged 50 years and above had significantly increased odds of having poor TB treatment outcomes (OR = 6.16, 95% CI 2.39-15.83) compared to those aged 18 to 29 years. Those who were HIV positive had significantly increased odds of having poor TB treatment outcomes (OR=1.99, 95% CI: 0.99-4.01) compared to those who had unknown HIV status. Patients that resided in Stanza B had a successful treatment rate of 90% and statistically significant reduced odds (OR=0.36, 95% CI:
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0.11-1.18) of having poor treatment outcomes compared to those that came from Holani C/Itsoseng clinic (the reference location).
Conclusion
• The rate of successful TB treatment outcomes among Mamelodi Township patients was higher than the target set by the WHO.
• Age (40 years and above) and being HIV positive were significantly associated with poor treatment outcomes.
• Specific therapies and approaches are needed targeted for TB patients aged 40 and older as well as those that are HIV positive.
Keywords: Tuberculosis, Poor TB treatment outcomes, Mamelodi Township, risk factors, default,