Pulmonary Tuberculosis Trends and Treatment Outcomes In The Gomoa West District,Ghana

OBJECTIVES: The objectives of the study were to assess the distribution of disease and treatment outcomes of pulmonary tuberculosis and identify factors associated with unsuccessful treatment outcomes. Identification of these factors help mul-tifaceted interventions targeting these factors to be recommended. METHODS: The medical charts of all new persons diagnosed as pulmonary TB either by AFB smear culture or radiography and captured in the district tuberculosis register from January 2010 to December 2015 were reviewed. Patients were categorized as having a successful(cured or completed treatment)or unsuccessful(default,failure,death or unknown) treatment outcome .The association of demographic and clinical factors such as age,sex,employment,health insurance status,subdistrict of abode,co-morbidities,orientation of disease and bacilli smear score with success of treatment, was evaluated by univariate and multivariate logistic regression using Stata. RESULTS: Of 154 patients, 124(83.2%) had successful treatment outcomes whiles 30(16.8%) had unsuccessful treatment outcomes. Of those with poor treatment outcomes, 5(3.36%) had treatment failure, 4(2.68%) defaulted, 7(4.70%) died, and 9(6.04%) had unknown treatment outcomes. Forty one (26.6%) of cases occurred in the Apam, 27(17.5%) in Mumford, 28(18.2%) in Dago, 17(11.0%) in Onyadze, 15(9.7%) in Osedze and 26(16.9%) in Oguaa subdistricts.On multivariate analysis, cases from Gomoa Oguaa sub-district (AOR 4.34; 95% CI 1.32-14.24) and old age (above 65 years) were significantly associated with unsuccessful treatment outcomes. CONCLUSIONS: In this study area, treatment success rate was found to be high. However there is the need to focus intervention among older patients above 65 years and the Gomoa Oguaa sub-district in order to ensure higher rates of treatment outcomes. It is imperative to enhance pulmonary tuberculosis education and surveillance in the Apam sub-district to reduce incidence of cases.