Pattern of default among tuberculosis patients on directly observed therapy in rural primary health care centres in Ogun State, Nigeria

Abstract

This study was designed to identify risk factors associated with defaulting during TB treatment and indicate specific adjustments to be made. This study is a retrospective, cohort study. Information on all TB patients attending clinic for treatment from 1st April 2004 to 30th June 2007 was collected using a data collection form. A total sample of 938 patients was reviewed. The overall default rate among the TB patients was 14.4% and was about half (44.3%) of the entire negative outcome. 743 (79.2%) of cases were cured or completed treatment and 9 (1.0%) of cases were transferred out. Factors associated with default were return after default (p = 0.000), presentation with extra-pulmonary TB (p = 0.000) and defaulting in the first two months of treatment (p = 0.00). There was no statistically significant difference in the rate of default between HIV positive and HIV negative TB patients (22.8% vs 10.5%, X2 = 0.15, p = 0.699) and distance of domicile from PHC centres (p = 0.91). This study suggest that National TB control programmes should pay a closer attention to the issue of home visit and monitoring especially among  patients with smear-negative PTB or EPTB and those returning after default in African population.   Keywords: Tuberculosis,default rate,primary health care,directly observed theraphy.