Factors associated with unsuccessful treatment outcome in tuberculosis patients among refugees and their surrounding communities in Gambella Regional State, Ethiopia

BackgroundTuberculosis (TB) is a leading cause of public health challenges among immigrant refugees and their surrounding communities in developing countries. Evaluating the treatment outcome of TB patients is one of the key indicators to understand the performance of TB control program. Hence, this study aims to assess profile, treatment outcome and factors associated with unsuccessful outcome of TB patients treated under the TB control program among refugees and their surrounding communities (SCs) in Gambella Regional State, Ethiopia.MethodologyRetrospective study was conducted in the health facilities of refugee and their SCs in Gambella Regional State from March 1 to May 30, 2017. Demographic and related data of all TB patients registered in TB Control Program between September, 2008 and October, 2017 in health facilities of refugee and the SCs was extracted using data extraction format. Eight years trend of TB, treatment outcome and factors associated with unsuccessful outcome among refugees and the SCs were computed using SPSS version 20.0 software.ResultA total of 886 refugees and 3284 SCs TB patients, registered for anti TB treatment in the last eight years, were evaluated in the study. The trend of all forms of TB is progressively increasing among refugees contrary to the SCs in the course of the study period (X2 trend = 207.7; P2 = 185.834; P2 = 170.915; P2 = 92.887; PConclusionThe study confirmed that there was low treatment success rate among refugees compared to the SCs. Being refugee, retreated case, patient’s age ≥35 years old, EPTB form, gender, rural patient address and HIV status were predictor factors for unsuccessful treatment outcome. Hence, the study urges the need for strengthened TB prevention program among refugees with due consideration of identified predictor factors to prevent the potential effect of hosting refugee to the SCs and the nations at large.研究背景 结核病（Tuberculosis, TB）是发展中国家移民难民及其周边社区（Surrounding Communities, SCs）面临的主要公共卫生挑战之一。评估结核病患者的治疗结局，是衡量结核病防控项目实施成效的核心指标之一。因此，本研究旨在评估埃塞俄比亚甘贝拉州难民及其周边社区（SCs）中，接受结核病防控项目治疗的结核病患者的患病特征、治疗结局，以及与治疗结局不良相关的影响因素。 研究方法 本研究于2017年3月1日至5月30日期间，在甘贝拉州的难民及其周边社区（SCs）医疗卫生机构中开展回顾性研究。采用数据提取记录表，提取2008年9月至2017年10月期间，在上述医疗卫生机构中登记并纳入结核病防控项目的所有结核病患者的人口学及相关临床资料。使用SPSS 20.0统计软件，分析难民与周边社区（SCs）结核病患者8年间的结核病流行趋势、治疗结局，以及治疗结局不良的相关影响因素。 研究结果 本研究共纳入过去8年间登记接受抗结核治疗的886名难民结核病患者与3284名周边社区（SCs）结核病患者进行分析。研究期间，难民群体的各类结核病流行趋势呈持续上升态势，而周边社区（SCs）则未出现该趋势（χ²趋势=207.7；P²=185.834；P²=185.834；P²=170.915；P²=92.887；P）。 研究结论 本研究证实，难民群体的结核病治疗成功率低于周边社区（SCs）。难民身份、复治病例、患者年龄≥35岁、肺外结核（Extrapulmonary Tuberculosis, EPTB）分型、性别、农村住址以及HIV感染状态，均为治疗结局不良的预测因素。因此，本研究呼吁应结合本研究明确的上述预测因素，强化针对难民群体的结核病防控项目，以规避收容难民对周边社区（SCs）乃至整个国家可能带来的潜在公共卫生影响。