Long-term survival experience of tuberculosis patients in a rural district of Ghana

Martin Badagda Lugutuah 1, 2, *, Edmund Baah-Akyeamfour 1, Daniel Boateng1 George Borogyante Atanga 1, Richmond Dery Nangsangna 1, Emmanuel Apetigah 1, Emmanuel Kwaku Nakua 1 and Jim Todd 3

1 Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
2 Ajumako Enyan Essiam District Health Directorate, Central Region, Ghana.
3 London School of Hygiene and Tropical Medicine, London, UK.
 
Research Article
International Journal of Science and Research Archive, 2024, 11(01), 163–172.
Article DOI: 10.30574/ijsra.2024.11.1.0981
Publication history: 
Received on 19 October 2023; revised on 03 December 2023; accepted on 06 December 2023
 
Abstract: 
There are limited epidemiological studies on the survival of Tuberculosis (TB) patients in Ghana despite the high endemicity of TB in the country. The present study estimated the overall survival time of TB patients and developed a model to determine co-variates associated with death. This was a retrospective cohort study that employed a complete enumeration technique to review patient data from the TB register of the Ajumako Enyan Essiam District, Central Region, Ghana, between August and October 2023. All patients registered for TB care between 1st January 2018 and 31st December 2022, excluding patients with incomplete data and drug-resistant cases were included. We applied descriptive statistics, Kaplan-Meier survival analysis, Log-rank test, and a Cox proportional hazard model for multivariate analysis. Out of the 226 eligible patients, 149 (65.9%) were males, 205 (90.7%) were new cases and 37 (17.3%) were TB/HIV co-infected. Those who experienced death were 37 (16.4%), with an overall survival time of 5.5 months (95% CI = 5.4 – 5.7). Older age (aHR=2.6; 95% CI: 1.1-6.3), male gender (aHR=4.9; 95% CI: 1.7-14.3), relapsed TB patients (aHR=5.2; 95% CI: 2.4-10.9), and TB/HIV co-infected patients (aHR=7.1; 95% CI: 3.6-13.9) were implicated as plausible predictors for survival time to death of TB patients. We concluded there was a significantly low overall survival time for older age, male gender, relapsed TB patients, and TB/HIV co-infected patients. The provision of enhanced training for targeted health professionals and tailored community awareness creation can boost early case detection, treatment adherence, and improve overall survival.
 
Keywords: 
Survival Analysis; Kaplan-Meier; Tuberculosis; Long-term; Ghana
 
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