Evaluation of the tuberculosis control program for fako division of the south west region of cameroon: investigating factors affecting program effectiveness

CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 , PL180

Tuberculosis has been ranked one of the leading causes of death from infectious diseases in the world. Being a public health problem in Cameroon, the National Tuberculosis Control Program put in place by the state aims to fight tuberculosis through the implementation of international directives (Directly Observed Treatment Short course). The control programs must reach global targets of 70% detection and 85% treatment success rates as stated by the Millennium Development Goals. Implementing these directives in Cameroon has not met the 85% treatment success rate. In 2011, the national treatment success rate was 69%. South West Region recorded treatment success rate of 71.4% and 71.2% in 2011 and 2012 respectively. 

The main objective was to identify factors affecting Treatment Success Rate, the main indicator for the Tuberculosis Control Program effectiveness. 

Three treatment centers in Fako Division were randomly selected following stratification into government, not-for-profit and for-profit structures (Regional Hospital Buea, Baptist Hospital Mutengene, and Tiko Central Clinic respectively). Data on the profile and treatment outcomes of tuberculosis patients registered to these centers from January 2011-December 2012 were collected retrospectively. Descriptive statistics was used to obtain frequencies. A number of factors affecting treatment success were taken into consideration: year, sex, age, HIV status, treatment center, category of tuberculosis, type of tuberculosis and yearly quarter in which patient was cured. Binomial logistics regression was done to obtain significant values for these factors. Multinomial logistics was further done on significant factors. 

A total of 895 registered tuberculosis patient records were obtained from the three treatment centers, 416 (46.5%) female patients and 479 (53.5%) males. Characterizing the tuberculosis patients, 510 (57.0%) were smear positive pulmonary tuberculosis patients, 225 (25.1%) were smear negative, and 160 (17.9%) extra-pulmonary. Comparing Treatment Success Rate across the three centers, Baptist Hospital Mutengene had the highest value (94.97%), followed by Regional Hospital Buea (83.74%) and Tiko Central Clinic the least (73.13%). 
Conclusion: Patient registration year, treatment center, tuberculosis classification and HIV status were factors that significantly Treatment Success Rate, hence effectiveness of the program. Studies should be carried out to ascertain the role of socioeconomic factors.

Tuberculosis, Treatment Success Rate, DOTS