Background: Despite Tuberculosis (TB) being highly infectious, having equally high mortality rates, and being endemic in the northern region of Ghana, data on treatment evaluation is sparse. This novel study therefore sought to determine the correlates of unsuccessful treatment outcome of tuberculosis in the Tamale Metropolitan area in the Northern Region of Ghana. Methods: Records of TB patients were retrospectively reviewed from January 2017 to December 2021. Demographic and other clinically important information were extracted from patients’ folders in health facilities within the Tamale Metropolitan area. Binary logistic regression was used to assess the correlates of unsuccessful treatment at p ≤ 0.05 and 95% Confidence Interval (CI). Results: A total of 235 participants were sampled; 13.19% died, 5.96% of them defaulted treatment, 2.55% were lost to follow-up, and 0.43% experienced treatment failure. The unsuccessful treatment rate was found to be 22.12%. Human Immunodeficiency Virus (HIV) positive status [adjusted odds ratios (aOR) = 4.141, 95% (CI) = (1.28 - 13.36)] showed increased odds of resulting in unsuccessful treatment outcome, while visits by medical staff to patients on therapy [aOR = 0.043, 95% CI = (0.17 - 0.11)] resulted in lower odds of unsuccessful treatment outcome after adjusting for all other variables. Conclusion: In this novel study in the Tamale Metropolitan area, the unsuccessful treatment rate was high. And so in order to achieve the 2035 “End TB strategy”, it’s imperative to improve the supervision of patients on therapy while scaling up the fight against TB/HIV coinfection both at the regional and national levels of Ghana.
Cite this paper
Angmortey, R. N. , Mohammed, A. , Sackeya, E. , Beru, M. M. , Baatira, M. , Moomin, A. , Sidiki, A. I. , Yelibora, M. A. , Nangsangna, R. D. and Opoku, D. A. (2025). Correlates of Unsuccessful Treatment among Persons Living with Tuberculosis in an Urban Setting in Northern Ghana. Open Access Library Journal, 12, e14085. doi: http://dx.doi.org/10.4236/oalib.1114085.
Torpey, K., Agyei-Nkansah, A., Ogyiri, L., Forson, A., Lartey, M., Ampofo, W., et al. (2020) Management of TB/HIV Co-Infection: The State of the Evidence. Ghana Medical Journal, 54, 186-196. https://doi.org/10.4314/gmj.v54i3.10
Yang, H., Ruan, X., Li, W., Xiong, J. and Zheng, Y. (2024) Global, Re-gional, and National Burden of Tuberculosis and Attributable Risk Factors for 204 Countries and Territories, 1990–2021: A Systematic Analysis for the Global Burden of Diseases 2021 Study. BMC Public Health, 24, Article No. 3111. https://doi.org/10.1186/s12889-024-20664-w
MacNeil, A., Glaziou, P., Sismanidis, C., Date, A., Maloney, S. and Floyd, K. (2020) Global Epidemiology of Tuberculosis and Progress toward Meeting Global Targets—Worldwide, 2018. Morbidity and Mortality Weekly Report, 69, 281-285. https://doi.org/10.15585/mmwr.mm6911a2
Citro, B., Soltan, V., Malar, J., Katlholo, T., Smyth, C., Sari, A.H., et al. (2021) Building the Evidence for a Rights-Based, People-Centered, Gender-Transformative Tuberculosis Response: An Analysis of the Stop TB Partnership Community, Rights, and Gender Tuberculosis Assessment. Health and Human Rights, 23, 253-267.
Adebisi, Y.A., Agumage, I., Sylvanus, T.D., Nawaila, I.J., Ekwere, W.A., Nasiru, M., et al. (2019) Burden of Tuberculosis and Challenges Facing Its Eradication in West Africa. International Journal of Infection, 6, e92250. https://doi.org/10.5812/iji.92250
Dogah, E., Aviisah, M., Kuatewo, D.M., Kpene, G.E., Lokpo, S.Y. and Edziah, F.S. (2021) Factors Influencing Adherence to Tuberculosis Treatment in the Ketu North District of the Volta Region, Ghana. Tuberculosis Research and Treatment, 2021, 1-6. https://doi.org/10.1155/2021/6685039
Addo, K.K., Ampofo, W.K., Owusu, R., Bonsu, C., Nartey, N., Mensah, G.I., et al. (2018) First Nationwide Survey of the Prevalence of TB/HIV Co-Infection in Ghana. Journal of Tuberculosis Research, 6, 135-147. https://doi.org/10.4236/jtr.2018.62013
Yahaya, A., Aquah, S.E.K. and Sagoe, K. (2014) Incidence of Pulmonary Tuberculosis (Per 100,000 People) in Northern Ghana (a Retrospective Study at the Tamale Teaching Hospital, 2004-2012). International Journal of Medical and Health Research, 3, 1-7. http://hdl.handle.net/123456789/1096
Ali, M.K., Karanja, S. and Karama, M. (2017) Factors Associated with Tu-berculosis Treatment Outcomes among Tuberculosis Patients Attending Tuberculosis Treatment Centres in 2016-2017 in Mogadishu, Somalia. Pan African Medical Journal, 28, 1-14.
Aliyu, G., El-Kamary, S.S., Abimiku, A., Blattner, W. and Charurat, M. (2019) Demography and the Dual Epidemics of Tuberculosis and HIV: Analysis of Cross-Sectional Data from Sub-Saharan Africa. PLOS ONE, 13, e0191387. https://doi.org/10.1371/journal.pone.0191387
Amo-Adjei, J. and Awusabo-Asare, K. (2013) Reflections on Tuberculosis Diagnosis and Treatment Outcomes in Ghana. Archives of Public Health, 71, Article No. 22. https://doi.org/10.1186/2049-3258-71-22
Tetteh, A.K., Agyarko, E., Otchere, J., Bimi, L. and Ayi, I. (2018) An Evaluation of Treatment Outcomes in a Cohort of Clients on the DOTS Strategy, 2012-2016. Tuber-culosis Research and Treatment, 2018, 1-7. https://doi.org/10.1155/2018/4287842
Ohene, S.A., Fordah, S. and Dela Boni, P. (2019) Childhood Tuberculosis and Treatment Outcomes in Accra: A Retrospective Analysis. BMC Infectious Diseases, 19, Article No. 749. https://doi.org/10.1186/s12879-019-4392-6
Osei, E., Oppong, S., Adanfo, D., Doepe, B.A., Owusu, A., Kupour, A.G., et al. (2019) Reflecting on Tuberculosis Case Notification and Treatment Outcomes in the Volta Region of Ghana: A Retrospective Pool Analysis of a Multicentre Cohort from 2013 to 2017. Global Health Research and Policy, 4, Article No. 37. https://doi.org/10.1186/s41256-019-0128-9
Abebe, G., Bonsa, Z. and Kebede, W. (2022) Treatment Outcomes and Associated Factors in Tuberculosis Patients at Jimma University Medical Center: A 5-Year Retrospective Study Gemeda. International Journal of Mycobacteriology, 6, 239-245.
Tola, A., Mishore, K.M., Ayele, Y., Mekuria, A.N. and Legese, N. (2019) Treatment Outcome of Tuberculosis and Associated Factors among TB-HIV Co-Infected Patients at Public Hospitals of Harar Town, Eastern Ethiopia. A Five-Year Retrospective Study. BMC Public Health, 19, Arti-cle No. 1658. https://doi.org/10.1186/s12889-019-7980-x
Bakare, A.M., Udunze, O.C., Bamidele, J.O., Omoniyi, A., Osman, E. and Daniel, O.J. (2021) Outcome of Community-Initiated Treatment of Drug-Resistant Tuberculosis Patients in Lagos, Nigeria. Transactions of the Royal Society of Tropical Medicine and Hygiene, 115, 1061-1065. https://doi.org/10.1093/trstmh/traa188
Mibei, D.J., Kiarie, J.W., Wairia, A., Kamene, M. and Okumu, M.E. (2016) Treatment Outcomes of Drug-Resistant Tuberculosis Patients in Kenya. The International Journal of Tuberculosis and Lung Disease, 20, 1477-1482. https://doi.org/10.5588/ijtld.15.0915
Asemahagn, M.A., Alene, G.D. and Yimer, S.A. (2020) A Qualitative Insight into Barriers to Tuberculosis Case Detection in East Gojjam Zone, Ethiopia. The American Jour-nal of Tropical Medicine and Hygiene, 103, 1455-1465. https://doi.org/10.4269/ajtmh.20-0050
Soeroto, A.Y., Nur-hayati, R.D., Purwiga, A., Lestari, B.W., Pratiwi, C., Santoso, P., et al. (2022) Factors Associated with Treatment Outcome of MDR/RR-TB Patients Treated with Shorter Injectable Based Regimen in West Java Indonesia. PLOS ONE, 17, e0263304. https://doi.org/10.1371/journal.pone.0263304
Ridolfi, F., Peetluk, L., Amorim, G., Turner, M., Figueiredo, M., Cor-deiro-Santos, M., et al. (2023) Tuberculosis Treatment Outcomes in Brazil: Different Predictors for Each Type of Unsuc-cessful Outcome. Clinical Infectious Diseases, 76, e930-e937. https://doi.org/10.1093/cid/ciac541
Addo, S.O., Mensah, G.I., Mosi, L., Abrahams, A., Bonfoh, B., Kazwala, R., et al. (2021) Trends in Extrapulmonary TB Cases at Three Teaching Hospitals in Ghana, 2008-2017. Public Health Ac-tion, 11, 26-32. https://doi.org/10.5588/pha.20.0061
Ejeta, E., Beyene, G., Balay, G., Bonsa, Z. and Abebe, G. (2018) Factors Associated with Unsuccessful Treatment Outcome in Tuberculosis Patients among Refugees and Their Surrounding Communities in Gambella Regional State, Ethiopia. PLOS ONE, 13, e0205468. https://doi.org/10.1371/journal.pone.0205468
Attah, C.J., Oguche, S., Egah, D., Ishaya, T.N., Banwat, M. and Adgi-dzi, A.G. (2018) Risk Factors Associated with Paediatric Tuberculosis in an Endemic Setting. Alexandria Journal of Medicine, 54, 403-409. https://doi.org/10.1016/j.ajme.2018.05.002
Daniel, O.J. and Alausa, O.K. (2006) Treatment Outcome Southwestern Nigeria. https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=O J Daniel and O K Alausa&btnG=
Chakaya, J., Khan, M., Ntoumi, F., Aklillu, E., Fatima, R., Mwaba, P., et al. (2021) Global Tuberculosis Report 2020—Reflections on the Global TB Burden, Treatment and Prevention Efforts. International Journal of Infectious Diseases, 113, S7-S12. https://doi.org/10.1016/j.ijid.2021.02.107
Muture, B.N., Keraka, M.N., Kimuu, P.K., Kabiru, E.W., Ombeka, V.O. and Oguya, F. (2011) Factors Associated with Default from Treatment among Tuberculosis Patients in Nairobi Province, Kenya: A Case Control Study. BMC Public Health, 11, Article No. 696. https://link.springer.com/article/10.1186/1471-2458-11-696 https://doi.org/10.1186/1471-2458-11-696
Gelaw, Y.A., Assefa, Y., Magalhaes, R.J.S., Demissie, M., Tadele, W., Dhewantara, P.W., et al. (2020) Tb and HIV Epidemiology and Collaborative Service: Evidence from Ethiopia, 2011–2015. HIV/AIDS—Research and Palliative Care, 12, 839-847. https://doi.org/10.2147/hiv.s284722
Daftary, A., Mondal, S., Zelnick, J., Friedland, G., Seepamore, B., Boodhram, R., et al. (2021) Dynamic Needs and Challenges of People with Drug-Resistant Tuberculosis and HIV in South Africa: A Qualita-tive Study. The Lancet Global Health, 9, e479-e488. https://doi.org/10.1016/s2214-109x(20)30548-9
Woimo, T.T., Yimer, W.K., Bati, T. and Gesesew, H.A. (2017) The Prevalence and Factors Associated for Anti-Tuberculosis Treatment Non-Adherence among Pulmonary Tuberculosis Patients in Public Health Care Facilities in South Ethiopia: A Cross-Sectional Study. BMC Public Health, 17, Article No. 269. https://doi.org/10.1186/s12889-017-4188-9
Garfein, R.S., Liu, L., Cuevas-Mota, J., Collins, K., Muñoz, F., Catanzaro, D.G., et al. (2018) Tuberculosis Treatment Monitoring by Video Directly Observed Therapy in 5 Health Districts, California, USA. Emerging Infectious Diseases, 24, 1806-1815. https://doi.org/10.3201/eid2410.180459