Non-Follow-Up of Pulmonary Tuberculosis Patients in Health Facilities and Associated Factors, Hoima, Uganda

Apolo Ayebale¹*, Harriet Babikako³, Joan N Kalyango^1,2, Jane Asiimwe⁴, Hilda Nansikombi¹, Martin Nabwana¹, Alice Nakato¹ and Achilles Katamba¹

1Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
²Department of Pharmacy, College of Health Sciences, Makerere University, Kampala, Uganda
³School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
⁴Kyambogo University, Kampala, Uganda

1Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda

*Corresponding Author: Apolo Ayebale, Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

Received: February 08, 2021; Published: June 10, 2021

Abstract

Introduction: The World Health Organization and Ministry of Health recommend monitoring of tuberculosis patients that are on treatment to assess for healing progress. Tuberculosis treatment success in Hoima district was only 68% in 2017 compared to the national target of 85%. About 55% of the smear positive tuberculosis patients remain positive at the end of two months of medication. Failure to examine sputum at the end of 2 months during treatment reduces chances of early detection of treatment failure.

Objective: The main objective of the study was to determine prevalence and factors associated with non-follow-up of pulmonary tuberculosis patients for the 2 months’ sputum examination in health facilities in Hoima, Uganda.

Methods: We conducted a cross sectional study of 435 pulmonary tuberculosis patients’ records from 1^st January 2017 to 31^st December 2018. The dependent variable was absence of 2 Months' sputum results and the independent variables included HIV status, directly observed treatment, facility location, facility ownership, distance and baseline sensitivity. The prevalence and it's 95% confidence interval was determined. Logistic regression was used to determine associated factors.

Results: The prevalence of two months’ sputum non-follow-up was found to be 26.9% (95%CI = 7.0 - 64.4). The factors associated with sputum non-follow-up included: positive versus negative HIV status (aPR = 1.48, P < 0.001), not on versus being on directly observed treatment (aPR = 1.31 P = 0.002), rural versus urban health facilities (aPR = 1.79, P = 0.006), private versus government health facilities (aPR = 2.05, P = 0.015), distance > 5 km versus ≤ 5 km (aPR = 1.38, P = 0.021) and baseline tuberculosis drug sensitivity (aPR = 1.44, P = 0.318) which confounded health facility location.

Conclusion: We found a high prevalence of sputum non-follow-up. Tuberculosis patients that were HIV positive, not on directly observed treatment, staying in a distance greater than 5km from the health facility and patients attending rural and private health facilities were likely to miss 2 months’ sputum follow-up.

Keywords: Factors; Associated; Sputum; Non-follow-up; Uganda

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Citation

Citation: Apolo Ayebale., et al. “Non-Follow-Up of Pulmonary Tuberculosis Patients in Health Facilities and Associated Factors, Hoima, Uganda”.Acta Scientific Medical Sciences 5.7 (2021): 21-30.

Copyright

Copyright: © 2021 Apolo Ayebale., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.