Treatment Success and associated factors among patients with Pulmonary Tuberculosis attending Kampala Capital City Authority health facilities: A retrospective cohort study

Abstract
TB treatment success remains low in Uganda at 82%, below the recommended WHO target (≥90%). Consequences of poor treatment outcome include; increased MDR-TB prevalence, treatment costs and death. Kampala Capital City Authority (KCCA) public health facilities are congested which compromises the care given to pulmonary tuberculosis patients (PTB) that affects the treatment success of patients. However, there is scarce information regarding factors that are associated with treatment success among PTB patients in KCCA public health facilities. General Objective: To determine the treatment success and associated factors among patients with pulmonary tuberculosis attending KCCA public health facilities in Kampala between July 2019 and June 2020. Methods: A retrospective cohort study that involved review of records for 772 PTB patients who were enrolled on TB treatment in five KCCA health facilities from July 2019 to June 2020. Data on sociodemographic and clinical factors was abstracted from health facility TB registers. Data was entered in epidata and analyzed using STATA_v14 software. A modified poison regression model with robust standard errors was used in analysis and risk ratios were reported. Results: Treatment success was 87.2% (CI: 84.2%-89.1%), PTB patients who cured accounted for 413 (53.5%) and 260 (33.7%) completed treatment. Factors associated with PTB treatment success were: being classified as a clinically diagnosed PTB patients (aRR= 0.8, CI: 0.53 - 0.94, P value =0.021) and having a positive HIV/AIDS status (aRR= 0.7, CI: 0.43 - 0.88, P value =0.006) reduced treatment success and having a community volunteer as a treatment supporter was associated with increased treatment success (aRR= 1.2, CI: 1.06 - 3.28, P value =0.028). Conclusion: Over 80% of PTB patients in KCCA public health facilities achieve treatment success although this is still below the WHO target. Factors associated with TB treatment success include; being classified as a clinically diagnosed PTB patient, having a positive HIV/AIDS status as factors that reduce treatment success and having a community volunteer as a treatment supporter improves treatment success. Efforts such as consistent follow-ups should be encouraged among clinically diagnosed and HIV/AIDS positive PTB patients. Additionally, community volunteers should be empowered to support PTB patients.
Description
Keywords
Treatment Success, Cured, Treatment completed, Tuberculosis
Citation
Tumusiime, C., Katamba, A., Nakiyingi, L., & Kalyango, J. (2022). Treatment Success and associated factors among patients with Pulmonary Tuberculosis attending Kampala Capital City Authority health facilities: A retrospective cohort study. medRxiv. https://doi.org/10.1101/2022.12.20.22283758