Treatment outcome of among DR-TB Patients in Nigeria: A 5 Year Review

Background: Drug Resistant Tuberculosis (DR-TB) is a critical threat to public health and Programmatic Management of DR-TB (PMDT) programs in various countries, as it is associated with high mortality and failure rates. Treating patients with DR-TB poses a serious challenge to the Government in terms of human and monetary resources as well as to the patients in terms of prolonged exposure to the second line drugs (SLD) and its antecedent adverse reactions (catastrophic cost). In Nigeria DR-TB treatment was commenced in 2010 with a lot of success and draw-backs. This study looked at the outcome of this intervention as it’s relate to treatment completed, cured, lost to follow up (LTFU), failed treatment, died and treatment success. Adverse drug Reaction (ADR) associated morbidity, mortality as it influences the outcomes was also considered. Methods: This study was a retrospective study from all DR-TB cases were identified from the National e-Tb manager data base from July 2010 to December 2014. Results: A total of 973 data of patient treated for DR-TB were studied with a median age of 34.6ys. There were 62%, males and 38% females. About 89% were Tb retreatment cases and 11% were new cases. About 56.6% have completed their treatment with 26% cases declared cured. There were 4% of cases loss to follow up (LTFU) and 12% of patients died during treatment. About 1.1% of failed treatment and were diagnosed pre-XDR-TB. No case of XDR was notified. The total success rate was 83%%. About 28% (P = 0.0001) had comorbidity and 47.6 (P = 0.0001) of the patients had ADRs. There was an increase in mortality (34.2%) in 2013 and 2014 with 34% cases of ADRs and 11% cases comorbidity, suggesting a linear relationship. Conclusion: This study shows that the treatment success rate in patients among DR-TB was about the national target, there is a decline in LTFU and mortality within the reporting period. Comorbidity and ADR are associated with poor clinical outcome; there is need to incorporate active drug safety management (aDSM) and specialist review and management for co morbidities as part of the management protocol.