Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study
Objective Although several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MD...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e062857.full |
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| author | Peter Agyei-Baffour Victoria Panford Emmanuel Kumah Collins Kokuro Prince Owusu Adoma Michael Afari Baidoo Adam Fusheini Samuel Egyakwa Ankomah Samuel Kofi Agyei |
| author_facet | Peter Agyei-Baffour Victoria Panford Emmanuel Kumah Collins Kokuro Prince Owusu Adoma Michael Afari Baidoo Adam Fusheini Samuel Egyakwa Ankomah Samuel Kofi Agyei |
| author_sort | Peter Agyei-Baffour |
| collection | DOAJ |
| description | Objective Although several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MDR-TB in the Ashanti Region, Ghana.Design A retrospective, cross-sectional analysis.Setting The study was conducted in the Ashanti Region, the second most populous region in Ghana. The regional MDR-TB register, which contains information on all patients with MDR-TB being treated at the various TB centres in the region, was analysed between February and May 2021.Participants The participants consisted of all registered patients with MDR-TB who were placed on treatment between 1 January 2015 and 31 December 2020. Patients were included in the analysis if their treatment outcome had been assigned. Patients with no record of treatment outcome were excluded from the study.Outcome measures The main outcome variable for the study was MDR-TB treatment outcome, standardised as ‘cured’, ‘treatment completed’, ‘treatment failure’, ‘died’ and ‘lost to follow-up’. A logistic regression model was fitted for factors associated with the outcome measure.Results Out of 159 patients included in the analysis, 86 (54.1%) were declared cured, 28 (17.6%) completed their treatment successfully, 6 (3.8%) were declared treatment failure, 12 (7.5%) were lost to follow-up and 27 (17.0%) died. The overall treatment success rate was 71.7%. Patients who were female (adjusted OR (AOR)=1.27, 95% CI: 1.18 to 1.39, p=0.023), younger (AOR=0.53, 95% CI: 0.19 to 2.11, p=0.012), had a higher level of education (AOR=1.12, 95% CI: 0.65 to 1.90, p=0.034), had a baseline body mass index of 18.5 kg/m2 or above (AOR=1.57, 95% CI: 1.23 to 2.47, p=0.011) and those who did not have a history of TB (AOR=0.47, 95% CI: 0.10 to 0.75, p=0.028) were more likely to have successful MDR-TB treatment outcomes.Conclusions Favourable treatment outcomes for patients with MDR-TB can be achieved in a resource-limited country. Although the recommended WHO target of ≥75% was not met, the current result (71.7% treatment success rate) is still commendable considering all the challenges associated with TB treatment in Ghana. |
| format | Article |
| id | doaj-art-d79002f1a8b24590847bc667db6a7913 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
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| spelling | doaj-art-d79002f1a8b24590847bc667db6a79132025-01-31T15:10:08ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2022-062857Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional studyPeter Agyei-Baffour0Victoria Panford1Emmanuel Kumah2Collins Kokuro3Prince Owusu Adoma4Michael Afari Baidoo5Adam Fusheini6Samuel Egyakwa Ankomah7Samuel Kofi Agyei8Department of Health Policy, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Public Health, Kumasi South Hospital, Kumasi, GhanaHealth Administration and Education, University of Education, Winneba, Winneba, Central, GhanaDepartment of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaHealth Administration and Education, University of Education, Winneba, Central, GhanaDepartment of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, GhanaDepartment of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New ZealandDepartment of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New ZealandDepartment of Physician Assistantship, Faculty of Health and Medical Sciences, Presbyterian University College of Ghana, Asante Akyem Campus, GhanaObjective Although several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MDR-TB in the Ashanti Region, Ghana.Design A retrospective, cross-sectional analysis.Setting The study was conducted in the Ashanti Region, the second most populous region in Ghana. The regional MDR-TB register, which contains information on all patients with MDR-TB being treated at the various TB centres in the region, was analysed between February and May 2021.Participants The participants consisted of all registered patients with MDR-TB who were placed on treatment between 1 January 2015 and 31 December 2020. Patients were included in the analysis if their treatment outcome had been assigned. Patients with no record of treatment outcome were excluded from the study.Outcome measures The main outcome variable for the study was MDR-TB treatment outcome, standardised as ‘cured’, ‘treatment completed’, ‘treatment failure’, ‘died’ and ‘lost to follow-up’. A logistic regression model was fitted for factors associated with the outcome measure.Results Out of 159 patients included in the analysis, 86 (54.1%) were declared cured, 28 (17.6%) completed their treatment successfully, 6 (3.8%) were declared treatment failure, 12 (7.5%) were lost to follow-up and 27 (17.0%) died. The overall treatment success rate was 71.7%. Patients who were female (adjusted OR (AOR)=1.27, 95% CI: 1.18 to 1.39, p=0.023), younger (AOR=0.53, 95% CI: 0.19 to 2.11, p=0.012), had a higher level of education (AOR=1.12, 95% CI: 0.65 to 1.90, p=0.034), had a baseline body mass index of 18.5 kg/m2 or above (AOR=1.57, 95% CI: 1.23 to 2.47, p=0.011) and those who did not have a history of TB (AOR=0.47, 95% CI: 0.10 to 0.75, p=0.028) were more likely to have successful MDR-TB treatment outcomes.Conclusions Favourable treatment outcomes for patients with MDR-TB can be achieved in a resource-limited country. Although the recommended WHO target of ≥75% was not met, the current result (71.7% treatment success rate) is still commendable considering all the challenges associated with TB treatment in Ghana.https://bmjopen.bmj.com/content/12/7/e062857.full |
| spellingShingle | Peter Agyei-Baffour Victoria Panford Emmanuel Kumah Collins Kokuro Prince Owusu Adoma Michael Afari Baidoo Adam Fusheini Samuel Egyakwa Ankomah Samuel Kofi Agyei Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study BMJ Open |
| title | Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study |
| title_full | Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study |
| title_fullStr | Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study |
| title_full_unstemmed | Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study |
| title_short | Treatment outcomes and associated factors among patients with multidrug-resistant tuberculosis in Ashanti Region, Ghana: a retrospective, cross-sectional study |
| title_sort | treatment outcomes and associated factors among patients with multidrug resistant tuberculosis in ashanti region ghana a retrospective cross sectional study |
| url | https://bmjopen.bmj.com/content/12/7/e062857.full |
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