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Determinants of Treatment Failure among New Smear Positive Pulmonary Tuberculosis Patients, Northwest Ethiopia: A Case-Control Study

Simeneh Mekonnen

Introduction: Despite the accessibility of curable anti-tuberculosis medications, tuberculosis (TB) treatment failure is still challenge to the health and economic burden. As a result the patient remains main source of infection in the public and may lead to develop Resistance TB, as a consequence less productivity and lack of ability to work.

Methods: Unmatched case control study design was conducted among 94 cases and 196 controls from January to May 2018. Cases and controls were selected from health centers and government hospitals using systematic random sampling. Binary logistic regression analysis was used to identify factors.

Results: Patients age 30-39 years were 20% more likely risk for treatment failure as compared with age 40 and above (AOR=0.80; 95% CI:0.73-0.92), patients with a family size of 5 and above were 2.81 times more likely risk for TB treatment failure as compared with a family size of less than three (AOR=2.81; 95% CI: 1.70-4.64), patients co-infected with HIV were 3.79 times more likely risk for TB treatment failure as compared with HIV negatives (AOR=3.79; 95% CI:1.67-8.60), and duration of cough greater than 9 weeks were 6.84 times more likely risk for TB treatment failure as compared with cough of less than 5 weeks (AOR=6.84; 95% CI: 4.31-9.37) and Patients with positive smear result at two months were also 7.92 times more likely risk for treatment failure (AOR=7.92; 95% CI: 3.56-17.60) as compared with negative smear result patients were factors significantly associated with treatment failure.

Conclusion: TB treatment failure was associated with older age, large family size, co-infected with HIV, long duration of cough before diagnosis and positive sputum smear at end of two months. Hence, service providers should provide strict follow up for TB patients co-infected with HIV and patients of positive smear at end of two months during the course of treatment.