Determinants of Treatment Outcome of Public-Private Mix Tuberculosis Control Programme in South-Eastern Nigeria

HA Efegbere, AE Anyabolu, AN Onyeyili, EK Efegbere, N Sani-Gwarzo, A Omoniyi, RC Okonkwo, OP Eze, MU Oguwuike, EH Enemuo, PO Adogu, AL Ilika, AO Igwegbe, IC Oyeka

Abstract


Background: Determinants for non-compliance to antituberculosis
treatment range from a poor correlation
between patient and programme needs and priorities
among other socio-economic factors.
Objectives: This is to assess determinants of treatment
outcome of public private mix tuberculosis control
programme in South-Eastern Nigeria.
Methods: A retrospective cohort study design using
Multivariate Logistic Regression to analyze secondary data
set (2007-2010) of patients to assess determinants of TBDirectly
Observed Treatment Short course Treatment
outcomes in public and private facilities in Anambra State.

Results: A total of 2,018 patients (1,899 patients in public
health facilities and 119 in private health facilities) were
reviewed. The mean ages in public and private facilities
were 34.0±4.2 years and 32±3.7 years. Males were 60.0%
(1100 patients) and 75%(90 patients) at public and private
health facilities respectively. Cure rates of 37.6%(714
patients) and 48.7%(61patients);Defaulter rates of
28.2%(532 patients) and 7.6%(9 patients); Interruption
rates of 3.9%(74 patients) and 0%(0 patients); Transfer-out
rates of 3.2%(61 patients) and 1.7% (2 patients);Failure
rates of 1.9%(36 patients) and 0.8%(1 patient);Death rates
of 4.1%(78 patients) and 0.8%(1 patient); and treatment
completion rates of 19.7%(375 patients) and 6.7%(8
patients) were found at public and private health facilities
respectively.

Conclusion: Determinants that affected treatment
outcome for public facilities were year, HIV status of patients,
category of treatment, sex and age of patients. The
determinant for private facilities was only year. Future
research should focus on identifying factors that influence
health seeking behaviour to accessing care in private
facilities


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