1. Daffodil International University (DIU), Dhaka Bangladesh
AN EVALUATION OF TREATMENT OUTCOME IN TUBERCULOSIS DIRECTLY OBSERVED TREATMENT SHORT COURSE (DOTS) FACILITIES IN JIGAWA STATE, NIGERIA (2010–2014) BY
MUHAMMAD FAISAL
Daffodil International University (DIU), Dhaka Bangladesh
FEBRUARY 2016

2. BACKGROUND
Tuberculosis (TB) is a major public health problem worldwide.
One third of the world population (2 Billion people) have TB infection.
Tuberculosis (TB) is contagious and airborne. It ranks alongside HIV as a leading cause of death worldwide.
9.6 million people are estimated to have fallen ill with TB in 2014: 5.4 million men, 3.2 million women and 1 million children.
An estimated 1.2 million people living with HIV developed TB in

3. Cont’d
Top 10 countries with TB patients are India, China, Indonesia, Nigeria, South Africa, Bangladesh, Ethiopia, Pakistan, Philippines and Democratic Republic of the Congo.
In Africa, there are about 1.6 million new cases of TB yearly with about 600,000 deaths.
Nigeria is rated 4th among the 22 countries Worldwide with high TB burden.
In Jigawa state, DOTS is being practiced in all the 27 Local government areas. Coordinated by the State TB Leprosy Control Program (STBLCP).

4. JUSTIFICATION
This Research is not an entirely new research area. The study will try to evaluate the treatment outcome and socio-demographic factors that are related to it.
The study will help to reduce/decrease the mortality and morbidity of the disease in the communities and hence reducing the spread of the disease.
The policymaker can take necessary steps to make people aware about the associated risk factors of TB.

5. Research Question
What is the treatment outcomes from Jigawa state TB patients and possible risk factors associated with the occurrence of the Tuberculosis in the State?

6. Objectives of the study
GENERAL OBJECTIVE:
To evaluate the treatment outcome in TB DOTS facilities in Jigawa State.
SPECIFIC OBJECTIVES
To determine the TB treatment outcome in Jigawa state.
To determine the factors influencing the treatment outcome of TB in Jigawa state.
To determine the prevalence of HIV among TB patients.

7. METHODOLOGY Research Design
This study was a retrospective cross sectional study.

8. Study Population, period of study and sample size
The study population was all the TB patients that assessed treatment in the seven chosen local governments using the DOTS therapy in Jigawa State between the years 2010 –2014.
Study was carried out from October 2015 to January 2016, Jigawa state, Nigeria.

9. Cont’d Sample size was determine by using below relation; n = z2pq d2
n = minimum sample size
z = Standard normal deviate (usually 1.96)
p = prevalence of TB in Nigeria which is 5.2%
q = 1–p
d = degree of freedom (0.05)
n = 76
The minimum sample size required for this study is 76.

10. Sampling Techniques and Data collection procedure
This research work was conducted by the use of stratified sampling techniques.
Data was collected from the various LGA TB control registers used for the study. The LG TB control registers contained basic information of the patients.
These information include date of registration, LGA TB no, name, age, sex, treatment unit/facility, date treatment started, treatment category, x- ray result (if applicable), etc.
JIGAWA STATE
JIGAWA NORTH WEST
JIGAWA NORTH EAST
JIGAWA SOUTH WEST

11. Data Analysis
Data was analyzed by using a software package used for statistical analysis i.e. Statistical Package for the Social Sciences (SPSS).

12. RESULTS

13. Table 1: Distribution of patients by Age (n=963)
 Age (years)
Frequency
Percentage (%)
0-19
122
12.7
20-29
243
25.2
30-39
221
22.9
40-49
169
17.5
50-59 89
9.2
60-69
119
12.4
Total
963
100
Mean age = 36 years, SD ± 7.97 

14. Figure 1: Distribution of patients by sex (n=963)

15. Figure 2: Distribution of patients by type of residence (n=963)

16. Figure 3: Distribution of patients by treatment outcome (n=963)

17. Figure 4: Prevalence of HIV Disease (n=963)

18. Table 2: Distribution of patients by disease classification (n=963)
Variables
Frequency
Percentage (%)
Disease classification
Pulmonary Extra pulmonary
930 33
96.6
3.4
Disease Category
Category 1
Category 2
833
130
86.5
13.5
Total
963
100

19. Table 3: Factors affecting treatment outcome (n=963)
Cured
Treatment
Died
Defaulter
Transfer
Failure
Total
Statistics
Smear type
+ve
-ve
378 55
166
202 33 18 61 20 12 5 9 4
659
304
X2=45.114
P=0.000
Category
CAT 1
CAT 2
309 59 42 71 10 11 6 8
820
143
X2=38.910
Disease classification
PTB
EPTB
349 19 48 3 75 17 13
927 36
X2=44.981
Residence
Urban Rural
283
150
272 96 72
686
277
X2=58.578
Sex
Male
Female
228
205
222
146 32 51 30
554
409
X2=38.284
P=0.002
Age (years)
≤19
20-29
30-39
40-49
50-59
60-69
122
243 68
127
169 26 1 80
221 89
119
X2=1.614
433
368 81
963

20. Conclusion
This study revealed a Treatment Success rate (TSR) in Jigawa State of Nigeria that is higher than the TSR of Nigeria, it also revealed a defaulter rate that is lower than the Nigerian average, a failure rate that is marginally lower and better than the Nigeria average using the WHO Global TB report. This study has shown a death rate which is close to the death rate of TB patients in Nigeria.

21. Recommendation
The state TB team should be commended for all their efforts in making sure that the state TB program is moving in the right direction.
DOTS should be extended to all the nooks and corners of the state so that there will be wider access to TB treatment.
TB HIV collaboration should be encouraged and enhanced. HIV testing should be extended to all TB patients while all HIV patients should be screened for TB.
Government should be encouraged to improve infrastructures, health policies, human resources development, service delivery at all health centers and DOTS clinics.
Proper observation and follow up of patients during treatment is needed.

22. THANK “U” ALL